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Yan K, Zhang RK, Wang JX, Chen HF, Zhang Y, Cheng F, Jiang Y, Wang M, Wu Z, Chen XG, Chen ZN, Li GJ, Yao XM. Using network pharmacology and molecular docking technology, proteomics and experiments were used to verify the effect of Yigu decoction (YGD) on the expression of key genes in osteoporotic mice. Ann Med 2025; 57:2449225. [PMID: 39749683 DOI: 10.1080/07853890.2024.2449225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/08/2024] [Accepted: 12/06/2024] [Indexed: 01/04/2025] Open
Abstract
BACKGROUND Yigu decoction (YGD) is a traditional Chinese medicine prescription for the treatment of osteoporosis, although many clinical studies have confirmed its anti-OP effect, but the specific mechanism is still not completely clear. METHODS In this study, through the methods of network pharmacology and molecular docking, the material basis and action target of YGD in preventing and treating OP were analyzed, and the potential target and mechanism of YGD in preventing and treating OP were clarified by TMT quantitative protein and experiment. RESULTS Network pharmacology and molecular docking revealed that the active components of YGD were mainly stigmasterol and flavonoids. Molecular docking mainly studied the strong binding ability of stigmasterol to the target. Animal proteomics verified the related mechanism of YGD in preventing and treating OP. Based on the KEGG enrichment of network pharmacology and histology, our animal experiments in vivo verified that YGD may play a role in the treatment of OP by mediating hif1- α/vegf/glut1 signal pathway. CONCLUSIONS YGD prevention and treatment of OP may be achieved by interfering with multiple targets. This study confirmed that it may promote osteoblast proliferation and protect osteoblast function by up-regulating the expression of proteins related to HIF signal pathway.
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Affiliation(s)
- Kun Yan
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Rui-Kun Zhang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jia-Xin Wang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Hai-Feng Chen
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yang Zhang
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Feng Cheng
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yi Jiang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Min Wang
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ziqi Wu
- The Third Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiao-Gang Chen
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhi-Neng Chen
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Gui-Jin Li
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin-Miao Yao
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Bocchi Martins JB, Amaral da Rocha AR, Fausto DY, da Silva E, da Silva G, Pinheiro GP, de Azevedo Guimarães AC. Comparing urban dance and functional fitness for postmenopausal women: A randomized clinical trial protocol. Eur J Obstet Gynecol Reprod Biol 2025; 310:113936. [PMID: 40188682 DOI: 10.1016/j.ejogrb.2025.113936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2025] [Revised: 03/24/2025] [Accepted: 03/26/2025] [Indexed: 05/23/2025]
Abstract
INTRODUCTION Physical exercise is a non-pharmacological treatment that can bring positive changes to menopausal women experiencing physiological and hormonal changes leading to various physical and psychological symptoms. This study introduces the MenosPausa Mais Movimento Project protocol, aiming to compare the effects of Urban Dance and Functional Fitness with a control group on the physical and psychological well-being of postmenopausal women. METHODS This study outlines a protocol for a three-arm randomized clinical trial involving two interventions (Urban Dance and Functional Fitness) lasting 12 weeks. The participants will be women in early postmenopause, aged between 40 and 59 years, assigned to three groups: (1) Urban Dance Intervention Group, (2) Functional Fitness Intervention Group, and (3) Control Group. Both interventions will consist of two weekly sessions lasting 60 min each. The outcomes to be assessed include physical aspects (body mass index, fat percentage, waist circumference, muscle strength, cardiorespiratory fitness, bone densitometry, sleep quality, urinary incontinence, sexual function, and follicle-stimulating hormone) as well as psychological aspects (stress, cognition, mood state, depressive symptoms, and anxiety). Data collection and analysis will be conducted during pre- and post-intervention periods. DISCUSSION The study is proposed with the aim of expanding the evidence related to the effects of different types of physical exercise in reducing and/or stopping symptoms resulting from menopause. The hypothesis is that women who perform the types of physical exercise will significantly improve the symptoms investigated when compared to those in the control group, thus expanding the possibilities of non-pharmacological therapies to assist the work of health professionals, favoring the physical and psychological aspects of this population.
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Affiliation(s)
| | | | | | - Emily da Silva
- State University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Giulian da Silva
- State University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Stracciolini A, Gearhart M, Quinn B, Sugimoto D. Quality of Life Measures in Young Pre-Professional Dancers Compared to Non-Athletes and Non-Dancer Athletes. J Dance Med Sci 2025; 29:84-90. [PMID: 39101401 DOI: 10.1177/1089313x241272138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Aim: To investigate quality of life (QoL) measures in a cohort of young female dancers. Methods: Cross-sectional survey study design was utilized to study dancers 8 to 17 years enrolled in two elite dance schools in the Boston area. The main outcome measure was the Pediatric Quality of Life (PedsQL 4.0) questionnaire, a validated QoL survey for children, with established normative values for comparison. Demographics and questions pertaining to training regimens and injury/illness history were also included. Sub-groups (8-11 years, 12-14 years, and 15-17 years) were created to analyze outcomes by age. Results: One hundred and forty emails were delivered, 72 were completed and included in the final data analysis (51.4%). The median scores for physical, psychosocial, emotional, social, and school PedsQL sub-scales were 87.5, 90.0, 80.0, 100.0, and 92.5, respectively. The median score of the total PedsQL scores was 88.8. No difference in QoL outcomes by age group was found (physical: P = .328; psychosocial: P = .918; emotional: P = .673; social: P = .573; school: P = 0.962; total: P = 0.766). 52.5% of the participants responded that they regularly perform in shows. Median hours/week of dance rehearsal was 10 hours (mean ± standard deviation: 10.3 ± 4.9; 95% CI: 9.0, 11.6; IQR: 7.0, 13.5; range: 2.0, 20.0) and 68.9% reported they practice and rehearse throughout the entire calendar year as opposed to solely during the school year; most dancers reported participating in dance 11 months (median value) per year (mean ± standard deviation: 10.7 ± 0.8; 95% CI: 10.5, 11.0; IQR: 10.0, 11.0; range: 9.0, 12.0). Conclusion: QoL measures for young female dancers were higher relative to existing data for the general population and lower compared to other sports participation. These results will support the social, emotional, and physical health of young dancers.
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Affiliation(s)
- Andrea Stracciolini
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Division of Emergency Medicine, Department of Medicine, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Marina Gearhart
- Graduate of Dance, Movement Therapy and Clinical Mental Health Counseling Lesley University, Cambridge, MA, USA
| | - Bridget Quinn
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dai Sugimoto
- Division of Sports Medicine, Department of Orthopedics, Boston Children's Hospital, Boston, MA, USA
- The Micheli Center for Sports Injury Prevention, Waltham, MA, USA
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
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Li R, Yan Q, Qu Y, Wang Y. Square dance, loneliness, quality of life, and attitude toward aging in middle-aged and older women in China. Front Public Health 2025; 13:1508556. [PMID: 40061464 PMCID: PMC11885143 DOI: 10.3389/fpubh.2025.1508556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 02/04/2025] [Indexed: 05/13/2025] Open
Abstract
Background With the ongoing advancement of society and the economy, population aging has emerged as an unavoidable global trend, leading to various social issues and exerting a profound impact on the physical and mental well-being of middle-aged and older adults. While women often face greater challenges than men during the aging process, particularly in terms of physical health vulnerabilities, mental health disparities and socioeconomic disadvantages. These factors underscore the importance of studying middle-aged and older women to better address their unique needs and promote healthy aging. Much attention has been paid to how middle-aged and older women can improve healthy aging, positive emotions and subjective well-being through regular physical activity. Methods Using 4,819 middle-aged and older women who participated in square dance exercise, structural equation modeling was used to explore the relationship between square dance exercise and attitude toward aging, as well as the chain-mediated effects of loneliness and quality of life. Results (a) Square dance exercise is a positive predictor of attitude toward aging in middle-aged and older women. (b) Loneliness and quality of life moderated the relationship between square dance exercise and attitude toward aging, and their mediating effects included three pathways. (c) The single mediating effect of quality of life was the largest compared to the chain mediating effects of loneliness and loneliness-quality of life. Conclusion This study aimed to reveal the reduction of loneliness and improvement of quality of life as potential mechanisms in the relationship between square dance exercise and attitude toward aging, and to emphasize that square dance exercise can be effective in promoting positive attitude toward aging and enhancing subjective well-being in middle-aged and older women.
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Affiliation(s)
| | | | | | - Yan Wang
- College of Education, Beijing Sport University, Beijing, China
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Bocchi Martins JB, Fausto DY, Sonza A, Coutinho de Azevedo Guimarães A. Jazz dancing for improving cardiorespiratory fitness, body composition, muscle strength, and sleep quality in postmenopausal women: a randomized clinical trial with 6- and 12-month follow-ups. Menopause 2025; 32:54-63. [PMID: 39729069 DOI: 10.1097/gme.0000000000002455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2024]
Abstract
OBJECTIVE The aim of the study was to analyze the effects of 16 weeks of Jazz Dance training compared to a control group in postmenopausal women, postintervention, and at the 6- and 12-month follow-ups, on cardiorespiratory fitness, body composition, muscle strength, and sleep quality. METHODS Two-arm randomized clinical trial with a total of 47 women (jazz dance intervention group [JDIG] [n = 23] and control group (CG) [n = 24]) with a mean age of 53.41 ± 2.8 y. Data collection was carried out at four times, baseline, postintervention, and 6- and 12-month follow-ups using the 6-minute walk test (cardiorespiratory fitness); bioimpedance (body composition); isokinetic dynamometry (muscle strength); and the Pittsburgh Sleep Quality Index (sleep quality). RESULTS In the intention-to-treat analysis, the results showed positive differences for the JDIG in cardiorespiratory fitness at all time points (P = 0.034) and in the group x time interaction (P = <0.001). Lower limb muscle strength showed differences from baseline to postintervention and from baseline to the 12-month follow-up for the concentric force ratio (P = 0.021; P = 0.009). However, for peak extension and flexion, the results were not positive for the JDIG. There was a short-term improvement in sleep duration for the JDIG (P = 0.001) and significant intergroup differences in subjective sleep quality, where the JDIG showed better results compared to the CG (P = 0.041). CONCLUSIONS Jazz Dance is effective for improving cardiorespiratory fitness (in the short, medium, and long term) and sleep quality (in the short and medium term); however, it does not seem to have presented sufficient intensity and duration for facilitating changes in body composition or increasing lower limb muscle strength in postmenopausal women.
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Casey M, Dabkowski E, de Gracia MRL, Moore KA, Kennedy GA, Porter JE, Nasstasia Y, Alvarenga ME. Socioecological factors influencing physical activity engagement for women across the menopausal transition: a systematic review. Menopause 2024; 31:433-446. [PMID: 38595173 DOI: 10.1097/gme.0000000000002337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
IMPORTANCE Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity. OBJECTIVE This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach. EVIDENCE REVIEW The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers. FINDINGS Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities. CONCLUSIONS AND RELEVANCE Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.
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Affiliation(s)
- Meghan Casey
- From the Institute of Health and Wellbeing, Federation University Australia, Ballarat, Victoria, Australia
| | - Elissa Dabkowski
- Collaborative Evaluation & Research Centre, Federation University Australia, Gippsland, Victoria, Australia
| | - Ma Regina L de Gracia
- Institute of Health and Wellbeing, Federation University Australia, Gippsland, Victoria, Australia
| | - Kathleen A Moore
- Institute of Health and Wellbeing, Federation University Australia, Gippsland, Victoria, Australia
| | | | - Joanne E Porter
- Director of the Collaborative Evaluation & Research Centre, Federation University Australia, Gippsland, Victoria, Australia
| | - Yasmina Nasstasia
- Institute of Health and Wellbeing, Federation University Australia, Mount Helen, Victoria, Australia
| | - Marlies E Alvarenga
- Institute of Health and Wellbeing, Federation University Australia, Berwick, Victoria, Australia
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Wu J, Yu Y, Qin K, Ou Z. Mechanisms connecting square dance to sleep quality among middle-aged and older Chinese females: serial mediation roles of social support and depressive symptoms. Front Public Health 2023; 11:1307596. [PMID: 38074751 PMCID: PMC10701395 DOI: 10.3389/fpubh.2023.1307596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Background Square dance is gaining increasing popularity among middle-aged and older Chinese women who are also at high risk of sleep disturbance. Although previous studies have shown exercise could improve sleep quality, the association between square dance and sleep quality remains to be discussed, and even less is known about the potential mechanism underlying this association. Purpose This study aims to investigate the relationship between square dance and sleep quality and test if social support and depressive symptoms together play a serial mediating role in the influence of square dance on sleep quality. Methods A cross-sectional study was conducted among 549 middle-aged and older Chinese females from September to December 2020 in Shao Yang City, Hunan Province of China, with ethics approval granted (SYU [2020]002). Square dance involvement was assessed by three questions about the time participants spent in square dance. Social support, depressive symptoms, and sleep quality were measured using the Pittsburgh Sleep Quality Index (PSQI), Social Support Self-Rating Scale (SSRS), and 9-item Patient Health Questionnaire (PHQ-9), respectively. The serial mediation model was analyzed by the bootstrapping method to assess whether social support and depressive symptoms mediate the relationship between square dance and sleep quality. Results Two-thirds of the participants had high involvement in square dance and most reported a moderate and high level of social support (98.54%). The prevalence of depressive symptoms and sleep disturbance was 19.49 and 26.78%, respectively. The serial mediation model showed a significant association between square dance and sleep quality, which was fully mediated by social support and depressive symptoms in a serial model (total effect c = -0.114, 95%CI = -0.227 to -0.001; direct effect c' = -0.036, 95% CI = -0.138 to 0.065; total indirect effect ab = -0.077, 95% CI = -0.139 to-0.016). Conclusion Our study extends the understanding of how square dance is associated with sleep quality through the serial mediating roles of social support and depressive symptoms. It provides crucial implications for developing square dance interventions to improve sleep quality among middle-aged and older Chinese females.
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Affiliation(s)
- Jun Wu
- School of Music and Dance, Shaoyang University, Shaoyang, Hunan, China
| | - Yong Yu
- School of Politics and Public Administration, Guangxi Normal University, Guilin, Guangxi, China
| | - Keke Qin
- School of Politics and Public Administration, Guangxi Normal University, Guilin, Guangxi, China
| | - Zhiwen Ou
- School of Marxism, Shaoyang University, Shaoyang, Hunan, China
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Qu Y, Liu Z, Wang Y, Chang L, Fan H. Relationships among Square Dance, Group Cohesion, Perceived Social Support, and Psychological Capital in 2721 Middle-Aged and Older Adults in China. Healthcare (Basel) 2023; 11:2025. [PMID: 37510466 PMCID: PMC10379668 DOI: 10.3390/healthcare11142025] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
(1) Background: Aging is a global phenomenon, and China's aging is extensive and rapid and already at the middle to upper level worldwide. Promoting social interaction and increasing positive psychological qualities in individuals are key components in helping people adapt to the physical and mental changes of the aging process. Among them, how middle-aged and older adults improve their physical and mental health through physical activity is of great concern. (2) Methods: This study measured the physical activity of 2721 middle-aged and elderly square dance participants across China, and structural equation modeling was applied to explore the relationship between square dance exercise and group cohesion as well as the role of perceived social support and psychological capital. (3) Results: The results showed that (a) square dance exercise positively predicts group cohesion among middle-aged and older adults. (b) Perceived social support and psychological capital mediate the relationship between square dance exercise and group cohesion, and the mediating role consists of three pathways: perceived social support alone, psychological capital alone, and perceived social support-psychological capital chain mediation. (c) The mediating effect of psychological capital alone is greater than the mediating effect of perceived social support alone and the mediating effect of the perceived social support-psychological capital chain. (4) Conclusions: This study provides support for the theory and practice of square dance exercise and intervention guidance for increasing positive psychological qualities and group dynamic levels in middle-aged and older adults.
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Affiliation(s)
- Yujia Qu
- School of Art, Beijing Sport University, Beijing 100084, China
| | - Zhiyuan Liu
- School of Psychology, Beijing Sport University, Beijing 100084, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
| | - Yan Wang
- School of Art, Beijing Sport University, Beijing 100084, China
| | - Lei Chang
- Sports Department, China Women's University, Beijing 100101, China
| | - Hongying Fan
- School of Psychology, Beijing Sport University, Beijing 100084, China
- Laboratory of Sports Stress and Adaptation of General Administration of Sport, Beijing 100084, China
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Li X, Peng A, Li L, Chen L. Association between walking and square dancing-oriented leisure-time physical activity and cognitive function among middle-aged and elderly people in Southwest China. BMC Geriatr 2023; 23:28. [PMID: 36646990 PMCID: PMC9841134 DOI: 10.1186/s12877-023-03737-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/09/2023] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Southwest China is facing a serious aging problem across the country, but the status of cognitive function in middle-aged and elderly people in this region is superior to the national average. This study intends to reveal the leisure-time physical activity (LTPA) pattern in this region and explore whether this pattern is beneficial for cognitive function. METHODS The data came from the 2019-2021 baseline survey on cognitive function of a natural population cohort conducted by West China Hospital of Sichuan University. A structured questionnaire was used to investigate the LTPA status of the participants, and the Mini-Mental State Examination was used to evaluate their cognitive function. Then, we used multiple linear regression to analyze the association between LTPA and cognitive level, and further subgroup analysis was carried out according to sex, age and waist-to-hip ratio. RESULTS A total of 2697 participants were enrolled, with an average age of 66.19 ± 6.68 years. The average cognitive function score was 27.23 ± 2.72, of which 8.60% indicated mild cognitive impairment. Their median LTPA level was 24.50 MET-hours per week, of which 70.37% reached the activity level recommended by WHO, with the main types being walking (1340 cases, 49.68%), square dancing (270 cases, 10.01%), or walking + square dancing (172 cases, 6.38%). Multiple linear regression showed that cognitive function increased with the amount of LTPA from 11.25 MET-hours/week to 36.40 MET-hours/week (β 0.09 for 11.25 ~ 24.50 MET-hours/week, β 0.38 for 24.50 ~ 36.40 MET-hours/week) but stabilized at more (β 0.39 for ≥36.40 MET-hours/week). The positive association persisted even for those who only walked (β 0.37 for 24.50 ~ 36.40 MET-hours/week, P = 0.008). CONCLUSIONS Middle-aged and elderly people in Southwest China hold a relatively high level of LTPA status, and walking and square dancing-oriented LTPA are positively correlated with cognitive function.
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Affiliation(s)
- Xu Li
- Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Anjiao Peng
- Department of Neurology, Joint Research Institute of Altitude Health, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lin Li
- Department of Clinical Research and Management, Center of Biostatistics, Design, Measurement and Evaluation (CBDME), West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China
| | - Lei Chen
- Department of Neurology, Joint Research Institute of Altitude Health, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
- Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, 610041, People's Republic of China.
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