This article analyzed the mechanism of Huangqi Simiao Decoction(HSD)for the treatment of type 2 diabetes mellitus(T2DM).The component targets of HSD and the related disease targets of T2DM were screened through network pharmacology.The protein-protein interaction(PPI)network of intersecting targets and the drug-component-intersecting target network were constructed to screen the potential active ingredients and targets.Molecular docking was performed using AutoDock Vina software to verify the interaction between potential components and core targets.The serum was tested by ultra performance liquid chromatography-tandem mass spectrometry,and multivariate statistical analyses,such as principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA),were used to search for the differential metabolites and related metabolic pathways of each group by combining with the MetaboAnalyst database.The same metabolic pathways were analyzed by combining the screened differential metabolites with the intersecting targets screened by network pharmacology.Network pharmacology showed that the nine core components of HSD for the treatment of T2DM were quercetin,kaempferol,stigmasterol,baicalein,β-sitosterol,flavodoxin,canthaxanthin,canthaxanthin,berberine,and berberine,and the five core targets included AKT1,TP53,TNF,IL6,and VEGFA.Molecular docking showed that the core components bound well to the target genes.Metabolomics showed that a total of 112 common differential metabolites were identified,of which 88 metabolites exhibited increased concentration and 24 metabolites decreased concentration after treatment with HSD.Enrichment analysis showed that HSD regulated the body metabolism of patients with T2DM,mainly related to seven metabolic pathways,such as amino acid metabolism and tricarboxylic acid cycle.The joint analysis of metabolomics and network pharmacology showed that both involved histidine metabolism,arginine and proline metabolic pathways.This study suggests that HSD has a good efficacy for T2DM.Based on the combined analysis of metabolomics and network pharmacology,it was found that the mechanism may be that the pharmacodynamic bases of quercetin,kaempferol,and stigmasterol in HSD enhance the effects on histidine metabolism,arginine and proline metabolic pathways by modulating a variety of metabolites,which provides the basis for further prevention and treatment of T2DM.

Background Currently, more and more infertility couples are opting for combined acupuncture to improve success rate of in vitro fertilization (IVF). However, evidence from acupuncture for improving IVF pregnancy outcomes remains a matter of debate. Objective To quantitatively summarized the evidence of the efficacy of acupuncture among women undergoing IVF by means of systematic review and meta-analysis. Methods Four English (PubMed, Web of Science, EMBASE, and Cochrane Register of Controlled Clinical Trials) and Four Chinese databases (Wanfang Databases, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and SinoMed) were searched from database inception until July 2, 2023. Randomized controlled trials (RCTs) that evaluated the acupuncture’s effects for women undergoing IVF were included. The subgroup analysis was conducted with respect to the age of participants, different acupuncture types, type of control, acupuncture timing, geographical origin of the study, whether or not repeated IVF failure, and acupuncture sessions. Sensitivity analyses were predefifined to explore the robustness of results. The primary outcomes were clinical pregnancy rate (CPR) and live birth rate (LBR), and the secondary outcomes were ongoing pregnancy rate and miscarriage rate. Random effects model with I 2 statistics were used to quantify heterogeneity. Publication bias was estimated by funnel plots and Egger’s tests. Results A total of 58 eligible RCTs representing 10,968 women undergoing IVF for pregnant success were identifified. Pooled CPR and LBR showed a signifificant difference between acupuncture and control groups [69 comparisons, relative risk (RR) 1.19, 95% confifidence intervals (CI) 1.12 to 1.25, I 2 =0], extremely low evidence; 23 comparisons, RR 1.11, 95%CI 1.02 to 1.21, I 2 =14.6, low evidence, respectively). Only transcutaneous electrical acupoint stimulation showed a positive effect on both CPR (16 comparisons, RR 1.17, 95%CI 1.06 to 1.29; I 2 =0, moderate evidence) and LBR (9 comparisons, RR 1.20, 95%CI 1.04 to 1.37; I 2 =8.5, extremely low evidence). Heterogeneity across studies was found and no studies were graded as high-quality evidence. Conclusion Results showed that the convincing evidence levels on the associations between acupuncture and IVF pregnant outcomes were relatively low, and the varied methodological design and heterogeneity might inflfluence the fifindings. (Registration No. PROSPERO CRD42021232430)

Long non-coding RNAs (lncRNAs), which are non-protein-coding transcripts, are emerging as novel biomarkers for cancer diagnosis. Their dysregulation is increasingly recognized to contribute to the development and progression of human cancers, including lung cancer. Linc00485 is a newly discovered cancer-related lncRNA; however, little is known about its role in lung cancer progression. In this study, we found that the expression of Linc00485 was significantly increased in human lung cancer tissue and associated with malignant phenotypes, including tumour-node-metastasis (TNM) stage, metastasis and relapse. Furthermore, the proliferative, migratory and invasive abilities of lung cancer cells in vitro were significantly enhanced by overexpression of Linc00485 but inhibited by its silencing. Mechanistically, Linc00485 regulated the expression of c-Myc by directly binding to miR-298; the effects of Linc00485 overexpression could be significantly reversed by a c-Myc inhibitor or small interfering RNA. Xenotransplantation experiments showed that Linc00485 silencing significantly weakened the proliferation potential of A549 cells in vivo. Overall, these findings indicate that Linc00485 overexpression down-regulates miR-298, resulting in the up-regulation of c-Myc and thereby promoting the development of lung cancer.

INTRODUCTION:Oesophageal cancer is one of the most common malignant tumours and has been identified as one of the leading causes of cancer death worldwide. Surgery is considered to be the optimal treatment for patients with resectable oesophageal cancer. Oesophagectomy for oesophageal cancer can significantly extend the survival period of patients and provide a potential opportunity for a cure. However, there is still controversy regarding which thoracic approach (right or left) during oesophagectomy for oesophageal cancer can lead to better surgical outcomes globally. This systematic review and meta-analysis will be performed to determine which thoracic approach during oesophagectomy will achieve longer patient survival and will be more beneficial for patients.METHODS AND ANALYSIS:We will search PubMed, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials and Google Scholar databases for relevant clinical trials published in any language before 1 October 2019. Randomised controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, tumour pathological stage and ethnicity will be performed.PROSPERO REGISTRATION NUMBER:CRD42019124133.ETHICS AND DISSEMINATION:Because this study will be based on published or unpublished records and studies, there is no need for ethics approval. The results of the study will be published in a peer-reviewed journal.

BACKGROUND:Lung cancer is one of the most common malignant tumors, and non-small cell lung cancer (NSCLC) accounts for about 85% of lung cancer diagnosed. For patients with resectable early stage non-small cell lung cancer, routine postoperative adjuvant therapy can significantly prolong overall patient survival and reduce the risk of cancer recurrence. With the emergence and maturity of molecular targeted therapy and immunotherapy, the postoperative chemotherapy strategy of lung cancer patients has changed a lot. To evaluate the efficacy of postoperative adjuvant therapy (platinum-based chemotherapy, platinum-based chemotherapy plus molecular targeted therapy, platinum-based chemotherapy plus anti-angiogenic agents, or platinum-based chemotherapy plus immunotherapy) with or without radiotherapy for patients with NSCLC, we will conduct a systematic review and meta-analysis of the published or unpublished relevant randomized controlled trials.METHODS:We will search PubMed (Medline), Embase, Google Scholar, Cancerlit, and the Cochrane Central Register of Controlled Trials for related studies published without language restrictions before June 20, 2019. Two review authors will search and assess relevant studies independently. Randomized controlled trials (RCTs) and quasi-RCTs studies will be included. We will perform subgroup analysis in different methods of postoperative adjuvant therapy for patients with resectable early NSCLC. Because this study will be based on published or unpublished records and studies, there is no need for ethics approval.RESULTS:The results of this study will be published in a peer-reviewed journal.CONCLUSION:This study will comprehensively compare the efficacy of platinum-based chemotherapy with that of molecular targeted therapy and immunotherapy for patients after surgery with resectable early NSCLC. Since large-sample randomized trials meeting the inclusion criteria of this study may be insufficient, we will consider incorporating some high-quality small-sample-related trials, which may lead to high heterogeneity and affect the reliability of the results.

Background: Video-assisted thoracoscopic surgery (VATS) is a kind of minimally invasive surgery with the advantages of small surgical incision, less surgical bleeding, and fewer hospitalization days. However, traditional thoracotomy has advantages in lymph node dissection and radical resection of tumors and the benefits of VATS compared with thoracotomy for lung cancer are controversial. This systematic review and meta-analysis will be conducted to evaluate the advantages and disadvantages of the 2 different surgical methods. Methods and Analysis: PubMed (Medline), Embase, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for relevant randomized controlled trials (RCTs), quasi-RCTs, and Hi-Q (high quality) prospective cohort trials published or unpublished in any language before March 1, 2019. Subgroup analysis will be performed in type of operation, tumor pathological stage, and ethnicity. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: As far as we know, this study will be the first time to compare and meta-analyze the efficacy of thoracoscopic lung cancer resection and thoracotomy. This study will provide high-quality and reliable evidence for clinicians’ decision-making by comparing published or completed but unpublished trials data. Because of the characteristics of disease and intervention methods, large sample size and RCTs may be insufficient. We will carefully consider the inclusion of small sample RCTs, but this may lead to high heterogeneity and affect the reliability of research results. PROSPERO registration number: CRD42018118427

BACKGROUND:Esophageal cancer (EC) is one of the most common malignant tumors with a poor prognosis and identified as one of the leading causes of cancer death in the world. Many studies have reported that the incidence of EC is closely related to the intake of alcohol, hot food, and hot beverages, as well as smoking and diet. However, there is a lack of studies on the quantitative analysis of these risk factors for EC. If the solid quantitative evidence of these risk factors is provided for the prevention of EC, the prevalence of EC can be effectively reduced. We will conduct a systematic review and meta-analysis of high risk factors for EC in order to provide reliable evidence for the prevention of EC.METHODS AND ANALYSIS:We will search PubMed (Medline), the Cochrane Central Register of Controlled Trials, Embase, and Google Scholar for related studies published without language restrictions before December 1, 2019. Two review authors will search and assess relevant studies independently. Trials used a case-control, cross-sectional, cohort studies, randomized controlled trials (RCTs), and quasi-RCTs will be included. We will perform subgroup analysis in sex, age, ethnicity, and region.RESULTS:The results of this study will be published in a peer-reviewed journal.CONCLUSION:We will perform a systematic review and meta-analysis of high risk factors for EC in order to provide reliable evidence for the prevention of EC. However, because of the characteristics of disease and intervention, large-sample trials that meet the inclusion criteria of this study may be insufficient. We will consider including some high-quality small-sample related trials, which may lead to high heterogeneity and affect the reliability of the results.

Background: Video-assisted thoracoscopic surgery (VATS) has developed rapidly and a variety of feasible technical methods have been formed. VATS is the main way of lung cancer resection nowadays with minor surgical incision and less bleeding. Robot-assisted thoracic surgery (RATS) is a revolution in surgical procedures and robotic pulmonary resection has been put to use by an increasing quantity of hospitals around the world. However, the widespread adoption of robot-assisted lung cancer resection is controversial. We aimed to evaluate quality metrics of these 2 different approaches of operation by this review and meta-analysis. Methods and Analysis: We will search Medline, Embase, Pubmed, Google Scholar, and the Cochrane Central Register of Controlled Trials for related literature published in any language before February 28, 2019. Propensity score matched comparative studies, prospective cohort studies; randomized controlled trials (RCTs) will be included. If sufficient data are available, we will perform subgroup analysis in different operative types of lung cancer resection. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: To our knowledge, this will be the first time to use meta-analysis to assess quality metrics of video-assisted thoracoscopic lung cancer resection and robot-assisted lung cancer resection. The results of this study will provide more proofs for researchers, clinicians, and patients with lung cancer to choose a suitable surgical procedure. There is not enough high-quality evidence of RCTs to be included, due to the characteristics of interventions. We will try to include some non-randomized controlled trials, small sample trails. Although our team has experience in carrying out a systematic review and meta-analysis, there may be high heterogeneity and low reliability of evidence, which is the limitation of this study.

Abstract Background: Esophageal cancer is one of the most common malignant tumors, characterized by early metastasis and high degree of malignancy. Its morbidity ranks 7th among all malignant tumors and its mortality ranks 6th. Postoperative adjuvant therapy after esophagectomy can significantly improve the overall survival rate of patients with locally resectable esophageal cancer. With the breakthrough and progress of immunotherapy, the possibility of cure of esophageal cancer is greatly improved. Some clinical trials have reported that programmed death 1 (PD1) and programmed death ligand 1 (PDL1) inhibitors alone, compared with traditional platinum-based chemotherapy, can benefit patients and effectively extend the overall survival period of patients. We will conduct a systematic review and meta-analysis on the comparison of the efficacy of immunotherapy (PD1 and PDL1 inhibitors) alone and traditional platinum-based chemotherapy, so as to provide a reliable basis for clinicians to formulate the best chemotherapy regimen for patients with esophageal cancer after esophagectomy. Methods: We will search Pubmed, Medline, Embase, Web of Science, Cancerlit, Google Scholar, and the Cochrane Central Register of Controlled Trials for related studies published before December 1, 2019 without language restrictions. Two review authors will search and assess relevant studies independently. Randomized controlled trials (RCTs) or quasi-RCTs, and prospective cohort studies will be included. We will perform subgroup analysis in sex, age, ethnicity, and tumor stage of esophageal cancer patients. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: The results of this systematic review and meta-analysis will provide a basis for clinicians to formulate the best chemotherapy regimen for patients, as well as a research clue for clinical researchers in this field. The results of this study will expand the treatment options for esophageal patients, but due to the nature of the disease and intervention, large sample clinical trials are not abundant, so we will include some high-quality small sample trials, which may cause high heterogeneity. PROSPERO registration number: CRD42019125000.

Background: The completeness of resection is an important prognostic factor for early resectable thymoma. Since its inception 2 decades ago, median sternotomy has been recognized as the gold standard method for the treatment of all types and stages of thyomas. Minimally invasive surgical techniques, including video-assisted and robot-assisted surgery, have been rapidly developed as an alternative to traditional open approach surgery. Compared with traditional open approach surgery, minimally invasive approach has better cosmetic effect, faster improvement of lung function, reduction of surgical trauma, length of stay, and complications. We believe that this is an appropriate time and there is a need for a systematic, comprehensive, and objective assessment of the 2 surgical modalities in order to provide reliable evidence for clinicians to determine the best treatment for patients with early resectable thymoma. Methods: Pubmed (Medline), Web of Science, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for relevant randomized controlled trials (RCTs), quasi-RCTs, and Hi-Q (high quality) prospective cohort trials published or unpublished in any language before March 1, 2020. Subgroup analysis will be performed in tumor pathological stage and ethnicity. PROSPERO registration number: CRD42019133724. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: This study will be the first to assess the efficacy and safety of median sternotomy recognized as the gold standard method for the treatment of all types and stages of thyomas and minimally invasive thymectomy for patients with early-stage thymoma. This study will assess whether minimally invasive thoracoscopic and robotic assisted thymectomy can be used as an alternative to traditional median sternotomy for patients with early resectable thymoma and provide high-quality and reliable evidence for clinicians' decision-making.

Background: Esophageal cancer (EC) is one of the most common malignant tumors with a poor prognosis and identified as one of the leading causes of cancer death in the world. Many studies have reported that the incidence of EC is closely related to the intake of alcohol, hot food, and hot beverages, as well as smoking and diet. However, there is a lack of studies on the quantitative analysis of these risk factors for EC. If the solid quantitative evidence of these risk factors is provided for the prevention of EC, the prevalence of EC can be effectively reduced. We will conduct a systematic review and meta-analysis of high risk factors for EC in order to provide reliable evidence for the prevention of EC. Methods and analysis: We will search PubMed (Medline), the Cochrane Central Register of Controlled Trials, Embase, and Google Scholar for related studies published without language restrictions before December 1, 2019. Two review authors will search and assess relevant studies independently. Trials used a case-control, cross-sectional, cohort studies, randomized controlled trials (RCTs), and quasi-RCTs will be included. We will perform subgroup analysis in sex, age, ethnicity, and region. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: We will perform a systematic review and meta-analysis of high risk factors for EC in order to provide reliable evidence for the prevention of EC. However, because of the characteristics of disease and intervention, large-sample trials that meet the inclusion criteria of this study may be insufficient. We will consider including some high-quality small-sample related trials, which may lead to high heterogeneity and affect the reliability of the results.

Background:Video-assisted thoracoscopic surgery (VATS) is a kind of minimally invasive surgery with the advantages of small surgical incision, less surgical bleeding, and fewer hospitalization days. However, traditional thoracotomy has advantages in lymph node dissection and radical resection of tumors and the benefits of VATS compared with thoracotomy for lung cancer are controversial. This systematic review and meta-analysis will be conducted to evaluate the advantages and disadvantages of the 2 different surgical methods.Methods and Analysis:PubMed (Medline), Embase, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for relevant randomized controlled trials (RCTs), quasi-RCTs, and Hi-Q (high quality) prospective cohort trials published or unpublished in any language before March 1, 2019. Subgroup analysis will be performed in type of operation, tumor pathological stage, and ethnicity.Results:The results of this study will be published in a peer-reviewed journal.Conclusion:As far as we know, this study will be the first time to compare and meta-analyze the efficacy of thoracoscopic lung cancer resection and thoracotomy. This study will provide high-quality and reliable evidence for clinicians' decision-making by comparing published or completed but unpublished trials data. Because of the characteristics of disease and intervention methods, large sample size and RCTs may be insufficient. We will carefully consider the inclusion of small sample RCTs, but this may lead to high heterogeneity and affect the reliability of research results.PROSPERO registration number:CRD42018118427

Abstract Background: The completeness of resection is an important prognostic factor for early resectable thymoma. Since its inception 2 decades ago, median sternotomy has been recognized as the gold standard method for the treatment of all types and stages of thyomas. Minimally invasive surgical techniques, including video-assisted and robot-assisted surgery, have been rapidly developed as an alternative to traditional open approach surgery. Compared with traditional open approach surgery, minimally invasive approach has better cosmetic effect, faster improvement of lung function, reduction of surgical trauma, length of stay, and complications. We believe that this is an appropriate time and there is a need for a systematic, comprehensive, and objective assessment of the 2 surgical modalities in order to provide reliable evidence for clinicians to determine the best treatment for patients with early resectable thymoma. Methods: Pubmed (Medline), Web of Science, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for relevant randomized controlled trials (RCTs), quasi-RCTs, and Hi-Q (high quality) prospective cohort trials published or unpublished in any language before March 1, 2020. Subgroup analysis will be performed in tumor pathological stage and ethnicity. PROSPERO registration number: CRD42019133724. Results: The results of this study will be published in a peer-reviewed journal. Conclusion: This study will be the first to assess the efficacy and safety of median sternotomy recognized as the gold standard method for the treatment of all types and stages of thyomas and minimally invasive thymectomy for patients with early-stage thymoma. This study will assess whether minimally invasive thoracoscopic and robotic assisted thymectomy can be used as an alternative to traditional median sternotomy for patients with early resectable thymoma and provide high-quality and reliable evidence for clinicians’ decision-making.