The tonal system of Cantonese is very different from that of Mandarin, which creates potential challenges for Mandarin speakers when learning Cantonese. The aim of this study was to explore second language (L2) production of Cantonese tones by advanced learners whose first language (L1) is Mandarin. Forty-one informants participated in a recording experiment to provide production data of Cantonese tones. The speech data were measured acoustically using the computer software Praat (Version 6.3.10) and were evaluated perceptually by native Cantonese speakers. The relationship between the acoustic analysis and perceptual evaluation was also explored. The acoustic and perceptual evaluations confirmed that, while the tones that the Mandarin learners of Cantonese produced were non-native-like, their production of the Cantonese T1 and T2 was good in general. Furthermore, the accuracy of the perceptual evaluations could be predicted based on the acoustic features of the L2 tones. Our findings are in line with hypotheses in current speech learning models, and demonstrate that familiar phonetic categories are easier to acquire than are unfamiliar ones. To provide a more complete picture of L2 speech acquisition, future research should investigate L2 tone acquisition using both production and perception data obtained from participants with a greater variety of L1s.
Hanieh Talebi, Seyed Alireza Dastgheib, Maryam Vafapour
et al.
Abstract Background This study aimed to assess the link between polymorphisms in the SLCO1B1 gene, responsible for the organic anion transporter polypeptide 1B1 (OATP1B1), and the risk of neonatal hyperbilirubinemia. Methods A comprehensive literature review was performed utilizing PubMed, Web of Knowledge, and CNKI, culminating on December 1, 2023, focusing on studies published before this date. The search employed relevant keywords and MeSH terms related to hyperbilirubinemia and genetic factors. The inclusion criteria focused on original case-control, longitudinal, or cohort studies, with no restrictions on language or publication year. Correlations were quantified as odds ratios (ORs) with 95% confidence intervals (CIs) using Comprehensive Meta-Analysis software. Results Thirty-six case-control studies drawn from 22 publications encompassed a total of 5,186 cases and 5,561 controls. Among these, 20 studies involved the rs2306283 polymorphism, with 2,602 cases and 2,832 controls, while 16 studies focused on rs4149056, including 2,584 cases and 2,729 controls. Sample sizes varied significantly, ranging from 41 to 447 cases and 47 to 544 controls. Pooled analysis indicated no significant associations for rs2306283 overall or within Asian and Caucasian subgroups; however, significant associations emerged within the Chinese subgroup under both the allele model (OR = 1.297, 95% CI 1.012–1.662, p = 0.040) and the dominant model (OR = 1.344, 95% CI 1.013–1.784, p = 0.041), suggesting a potential risk tied to the G allele. Conversely, the examination of rs4149056 revealed no significant associations across all comparisons, including ethnic subgroup analyses. Conclusions The results imply that polymorphisms rs2306283 and rs4149056 in the SLCO1B1 gene are generally not associated with the risk of neonatal hyperbilirubinemia in overall population. Nevertheless, rs2306283 may pose an increased risk within the Chinese population, while rs4149056 shows no significant correlations across various groups. Further research is needed to clarify these implications and investigate other genetic factors related to neonatal hyperbilirubinemia.
Abstract Background While clinical diagnosis of mental health issues focuses on factual details represented by literal language (e.g., the onset and process of the triggering event and duration of symptom), the relationship between metaphorical language and psychopathological experiences remains an intriguing question. Focusing on psychological trauma triggered by the 2019–2020 Hong Kong social unrest, this study explored the correlations between trauma victims’ quantitative metaphor usage patterns and their experience of specific Acute Stress Disorder (ASD) symptoms. Methods Forty-six individuals with trauma exposure within 28 days were recruited through convenience sampling. Each completed a 20– to 30-minute semi-structured interview and filled out the Chinese version of the Stanford Acute Stress Reaction Questionnaire (SASRQ; 1). Metaphors in the interviews were identified using the discourse dynamic approach (2), and clinically interesting categories related to trauma and emotion expression, as revealed by previous literature, were sorted out. Standardized frequencies of the categories were correlated with participants’ SASRQ scores of five major ASD symptoms, and the correlational patterns were interpreted from a discourse analytic perspective. Results The study reveals how metaphor usage patterns can reflect the speakers’ differentiated experiences of psychopathological symptoms. Compared with individuals who experienced less trauma, those more disturbed by the re-experiencing symptom were more inclined to use emotion-related metaphors and to metaphorize about the self and the self-society relationship. Individuals who experienced more severe anxiety and hyperarousal showed a heightened awareness of self-related issues and diminished attention to others. Those who suffered from more severe impairment in functioning produced more metaphors in the negative valence. Dissociation and avoidance, which were less experientially salient and intense than the others, were not significantly correlated with metaphor usage patterns. Conclusion This study establishes symptom-level metaphor usage patterns as a previously overlooked but interesting avenue in trauma evaluation, treatment, and research. While the study is confined to a single context, it nevertheless reveals the potential for metaphor research findings to be incorporated as useful materials in psychology education and therapist training.
We usually talk about food, the way it is served, its types, and its beauty aspects in terms of satisfying the pleasures of the human eye and sense of taste. Therefore, in gastronomy, the things above receive great attention. Unsurprisingly, culinary art institutions have been established up to the academic level since decades ago. However, this paper presents a slightly different field of gastronomy, namely gastronomy for the ancestral spirits prayer ceremony, named coki/cuki prayer in Hokkian language (祖祭) which is still practiced today by the Chinese Peranakan of Palembang or we can say “Peranakan Palembang”, South Sumatra. This ritual ceremony, which is hundreds of years old is quite interesting, carried out by people of Chinese descent, both Totok and Peranakan, old and young generations. This paper focuses only on the Chinese Peranakan in Palembang. From here the question arises, why is this custom still maintained in modern times, even though the costs involved are not small? What type of food shows cultural acculturation? From a gastronomic point of view, how are the dishes served arranged? Are there rules? Research data consists of photos and information obtained from informants, and also researchers’ observations of Chinese Peranakan Palembang families because they are considered to know more about and carry out the rules related to the teaching of Confucianism (Tan, 1979). Shenism (Gondomono, 2013) and filial piety or 孝xiào in Confucian religious teachings are two philosophical thinking to know the reason why this ceremony is still carried out today. The research method is descriptive qualitative. The data from the informants will be sorted based on the type of dish, and how it is served, then will be described qualitatively, so that an understanding will be gained regarding the preservation of this prayer ceremony. The novelty of this paper is to increase knowledge about the existence of the culinary for spirits and the philosophical background.
This short essay is an introduction to the study of the Mahāmudrātilaka (‘An Ornament of the Great Seal’), an important Buddhist tantric scripture of the Hevajra cycle. The text is a so-called uttaratantra (ancillary scripture) of the Hevajratantra. This cult emerged around ca. 900 CE in Eastern India and quickly rose to a position of prominence. In order to illustrate this point, first I discuss some historical references to the Hevajra cult: a lexicographical work, inscriptions, and testimony in Śaiva exegesis. I then contextualise the Mahāmudrātilaka among the Hevajra ancillary scriptures and share some notes on the purpose of such texts. I argue that such scriptures were meant to update a cult’s ritual and doctrinal palette in order to keep up with developments seen (and thought desirable to have) in rival schools. In the next section, I present the only known Sanskrit manuscript of the Mahāmudrātilaka, Staatsbibliothek zu Berlin, Preußischer Kulturbesitz Orientabteilung Hs. or. 8711, a late Nepalese copy dated 1827 CE, which can be shown to be a copy of a Vorlage dating to 1204 CE. Next, I compare the text transmitted therein to the Tibetan translation, Tōh. 420, and identify them as two recensions. I then proceed to discussing exegesis on the Mahāmudrātilaka, the works of *Gambhīravajra and *Prajñāśrīgupta; these texts are for now available only in their Tibetan translation. I also identify some testimonia of the Mahāmudrātilaka. Using all this evidence, I argue that the text cannot be much earlier than the late 11th century. Next, I present an overview of the text by means of examining selected passages and their most significant features, with special focus on the differences and similarities with the Hevajratantra, the internal references to other scriptures, and the text’s significant parallels with the Vajramālābhidhāna. I argue that the text is unapologetically antinomian and gnostic. In the second half of the paper, styled as an appendix, I select five blocks of verses, which I edit and translate: the first deals with the relationship between initiating master and disciple, the second provides some insights into the attitudes of tantric practitioners towards orthodox Buddhists, the third contains detailed instructions on how to gather the antinomian substances known as ‘nectars’, the fourth deals with communal worship in a rite known as the gaṇacakra, and the final one describes a somewhat rare and rather gruesome ritual meant to bestow the power of flight.
Xin Liu,1– 3 Gehang Ju,1– 3 Wenyu Yang,4 Lulu Chen,3,5,6 Nuo Xu,4 Qingfeng He,4 Xiao Zhu,4,* Dongsheng Ouyang1– 3,5,* 1Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Institute of Clinical Pharmacology, Central South University, Changsha, People’s Republic of China; 3Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha Duxact Biotech Co., Ltd, Changsha, People’s Republic of China; 4Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Shanghai, People’s Republic of China; 5Changsha Duxact Biotech Co., Ltd, Changsha, People’s Republic of China; 6Department of Pharmacy, Affiliated Hospital of Xiangnan University, Chenzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Dongsheng Ouyang, Changsha Duxact Biotech Co., Ltd, Lutian Road 28, Changsha, 410221, People’s Republic of China, Tel +86 0731-84805380, Email ouyangyj@163.com Xiao Zhu, Department of Clinical Pharmacy and Pharmacy Administration, School of Pharmacy, Fudan University, Zhangheng Road 826, Shanghai, 201203, People’s Republic of China, Tel +862151980024, Email xiaozhu@fudan.edu.cnAbstract: Escitalopram (SCIT) represents a first-line antidepressant and antianxiety medication. Pharmacokinetic studies of SCIT have demonstrated considerable interindividual variability, emphasizing the need for personalized dosing. Accordingly, we aimed to create a repository of parametric population pharmacokinetic (PPK) models of SCIT to facilitate model-informed precision dosing. In November 2022, we searched PubMed, Embase, and Web of Science for published PPK models and identified eight models. All the structural models reported in the literature were either one- or two-compartment models. In order to investigate the variances in model performance, the parameters of all PPK models were derived from the literature published. A representative virtual population, characterized by an age of 30, a body weight of 70 kg, and a BMI of 23 kg/m2, was generated for the purpose of replicating these models. To accomplish this, the rxode2 package in the R programming language was employed. Subsequently, we compared simulated concentration–time profiles and evaluated the impact of covariates on clearance. The most significant covariates were CYP2C19 phenotype, weight, and age, indicating that dosing regimens should be tailored accordingly. Additionally, among Chinese psychiatric patients, SCIT showed nearly double the exposure compared to other populations, specifically when considering the same CYP2C19 population restriction, which is a knowledge gap that needs further investigation. Furthermore, this repository of parametric PPK models for SCIT has a wide range of potential applications, like design miss or delay dose remedy strategies and external PPK model validation.Keywords: escitalopram, population pharmacokinetics, precision medicine, CYP2C19
Jingwen Zhang,1,* Liying Liu,1,* Manjia Zhu,2 Xiaoyan Zheng,1,3 Yun Liang,1 Ying Zhong,3 Jing Xu,1 Jie Yang1,3 1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 2Basic Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, People’s Republic of China; 3Sichuan Jinxin Xi’nan Women’s and Children’s Hospital, Chengdu, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jie Yang; Jing Xu, Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, People’s Republic of China, Tel +86 13882296714, Email jenny_yang_jie@126.com; 195940644@qq.comBackground: Over the past decade, acupuncture in the perioperative period has attracted great interest, and a growing number of related literature has been published.Purpose: To analyze the general information and identify the research hotspots and trends of acupuncture in perioperative medicine in the last 10 years by bibliometric analysis.Methods: We searched the Web of Science Core Collection for publications on acupuncture in perioperative medicine from 2013 to 2023. The articles and reviews were collected with no language restriction. CiteSpace and VOSviewer software were used for bibliometric and visual analysis of relevant literature.Results: A total of 814 bibliographic records were retrieved. Overall, the annual number of publications showed an increasing trend. China and its institutions were in a leading position regarding the publication number. With comparatively more scientific collaboration with China, the USA ranked second. Shanghai University of Traditional Chinese Medicine was the most prolific institution. Ha, In-Hyuk had the most publications, and Han JS and Lee A were the most cited authors. Medicine was the most popular journal and Journal of Clinical Oncology had the highest impact factor. “Acupuncture”, “electroacupuncture” and “postoperative pain” were the top three keywords. The most popular topics were postoperative pain, postoperative ileus, and postoperative nausea and vomiting according to the keywords and references. And the clusters of postoperative cognitive dysfunction, anxiety, and breast cancer attracted relatively more attention recently.Conclusion: This study summarized the research status, hotspots, and trends of acupuncture in perioperative medicine in the past decade, which may aid researchers in better understanding this field. The research hotspots primarily focused on postoperative pain management and postoperative gastrointestinal function. The research of acupuncture for postoperative cognitive dysfunction, cancer-related surgery, and psychological states were the main frontiers topics and may be the focus in the future.Keywords: acupuncture, perioperative medicine, post-operative, mid-operative, CiteSpace, VOSviewer
Szamantabhadra bódhiszattva a mahájána buddhizmus égi bódhiszattváinak egyike, a kelet-ázsiai buddhizmusban az i. sz. V. század óta tisztelet tárgya, akit számos módon jelenítenek meg a kelet-ázsiai művészetben. A rá vonatkozó első forrás a Lótusz szútra, amelyet Dharmaraksa fordított le először kínaira 286-ban Zheng fahua jing 正法華經címmel, később pedig a híres fordító, Kumáradzsíva (344–413) fordította le ismét 406-ban Miaofa lianhua jing 妙法蓮華經 címmel. Szamantabhadra a Lótusz szútra utolsó, „Szamantabhadra bódhiszattva buzdítása” (Puxian pusa quanfa pin 普賢菩薩勸發品) című fejezetében jelenik meg, amely a szútra gyakorlására ösztönzi a híveket. Feltehetően a Lótusz szútra hatása alatt íródott a Szamantabhadra vizualizációs szútrája (Guan Puxian pusa xingfa jing 觀普賢菩薩行法經, T.277) című mű, amely rendkívül részletes leírását adja Szamantabhadra megjelenésének hatagyarú elefántján. Ez az apokrif szöveg vizualizációs gyakorlatok elemeit tartalmazza, amelyek vélhetően Belső-Ázsiából származnak, valamint egy bűnbánat rituálét, amely az ebben az életben és az előzőekben elkövetett minden bűntől való megszabadulást tesz lehetővé. Szamantabhadra kultuszának harmadik forrása a Buddhávatamszaka-szútra, amelyet Buddhabhadra (359–429) fordított le kínaira 420-ban hatvan tekercsben, majd a Siksánanda (652–710) 699-ben nyolcvan tekercsben. A szöveg sajátossága, hogy a Buddha tanítását elsősorban bódhiszattvák közvetítik benne. Ezek egyike Szamantabhadra, aki a mű több mint harmadában beszél Buddha helyett. A Buddhávatamszaka-szútra két fejezete is említi Szamantabhadra nevét. Az egyik a „Szamantabhdra szamádhija” (Puxian sanmei普賢三昧), a másik a „Szamantabhadra gyakorlata” (Puxian xing 普賢行). A szútra IX. századi tibeti fordítása egy másik, „Szamantabhadra tanítása” című fejezetet is tartalmaz (Kun tu bzang po’i spyod pa bstan pa), amely a szútra egyik kínai fordításában sem található meg. Siksánanda azonban önálló műként kínaira fordította ezt a művet Da fangguang Puxian suo shuo jing 大方廣普賢所說經 (T. 298) címmel. A jelen tanulmány a „Szamantabhadra szamádhija” és a „Szamantabhadra tanítása” című fejezetek kínai változatának magyar fordítását tartalmazza a tibeti variánsokkal egybevetve.
BackgroundCaregiving and self-care are challenging for Chinese immigrants in the United States due to limited accessible support and resources. Few interventions exist to assist Chinese immigrant caregivers in better performing self-care. To address this gap in the literature, our team developed the Care Me Too app to engage Chinese immigrant caregivers in self-care and conducted a user experience test to assess its usability and acceptability.
ObjectiveThis paper aims to report the results of the app’s usability and acceptability testing with Chinese immigrant caregivers and to solicit participants’ feedback of the app design and functions.
MethodsA total of 22 Mandarin-speaking Chinese caregivers participated in the study, which consisted of 2 parts: the in-lab testing and the 1-week at-home testing. In-depth face-to-face interviews and follow-up phone interviews were used to assess user experience of the app’s usability and acceptability and to solicit feedback for app design and functions. Directed content analysis was used to analyze the qualitative data.
ResultsAmong the 22 participants, the average age was 60.5 (SD 8.1) years, ranging from 46 to 80 years; 17 (77%) participants were women and 14 (64%) had an associate degree or higher. Participants reported uniformly positive ratings of the usability and acceptability of the app and provided detailed suggestions for app improvement. We generated guidelines for mobile health (mHealth) app designs targeting immigrant caregivers, including weighing flexibility versus majority preferences, increasing text sizes, using colors effectively, providing engaging and playful visual designs and functions, simplifying navigation, simplifying the log-in process, improving access to and the content on the help document, designing functions to cater to the population’s context, and ensuring offline access.
ConclusionsThe main contribution of this study is the improved understanding of Chinese caregivers’ user experiences with a language-appropriate mHealth app for a population that lacks accessible caregiving and self-care resources and support. It is recommended that future researchers and app designers consider the proposed guidelines when developing mHealth apps for their population to enhance user experience and harness mHealth’s value.
ABSTRACT Safety and security are important elements in tourism and have been studied over the past few decades. China plays an important role in the global tourism industry as the leading source market in the world. However, no studies thus far have comprehensively reviewed and compared tourism safety and security research published both within and outside China. To fill the void, this study reviewed 160 publications on tourism safety and security from English- and Chinese-language academic journals selected between 1990 and 2018. A comparative automated content analysis (ACA) approach was adopted in this study to analyze and compare the major themes and concepts that emerged in the sample. The findings revealed that the Chinese and Western literature assume distinctive foci regarding tourism safety and security. Specifically, the English-language literature is more comprehensive and considers both the supply and demand sides of the tourism industry. On the other hand, the Chinese literature thoroughly examines the importance of tourism safety and security within the tourism development process. This study provides a broad overview of the research activities on tourism safety and security from both an insider’s and outsider’s perspectives. Future research directions are suggested.
The article is a continuation of the author’s cycle of works devoted to foreign cinematographic and stage adaptations of Russian classical literature for foreign audiences. The research material includes 17 American, European, Chinese, Indian, Japanese fiction films and TV series, one Broadway musical and 9 Russian films and TV series used for comparison. The paper analyses different theoretical approaches to intersemiotic translation, ‘de-centering of language’ as a modern tendency and intersemiotic translation of literary works in the context of intercultural communication. Key decisions about the interpretation of original texts are made by directors and their teams guided by at least three goals: commercial, creative and ideological. Intersemiotic translation makes use of such strategies as foreignization, domestication and universalization. The resignifying of a literary text by means of the cinematographic semiotic system is connected with such transformations as: a) reduction - omission of parts of the original; b) extension - addition, filling in the blanks, and signifying the unsaid; c) reinterpretation - modification or remodeling of the original in accordance with the director’s creative ideas. A challenge and at the same time one of the key points of intersemiotic translation is a difficult choice between the loyalty to the original, comprehensibility for the target audience and freedom of creativity. The research shows that transformations and use of different translation strategies can have both positive and negative consequences. Positive outcomes include: visualization and comprehension of the Russian cultural space; adaptation of Russian experiences for the target culture; retranslation of universal values expressed by the original. Negative consequences result in: the distortion of the original due to insufficient cultural literacy; purposeful deformation of cultural meanings for ideological reasons; erroneous interpretation of the literary text; deformation of the original macromeaning; preservation of the plot, but loss of the in-depth meaning of the original text. Any degree of creative freedom still requires intercultural competence and a careful choice of semiotic signs aimed at expressing the key ideas of the original.
Abstract Asia is the world's most linguistically diverse continent and its diversity largely conforms to established global patterns that correlate linguistic diversity with biodiversity, latitude, and topography. However, one Asian region stands out as an anomaly in these patterns—Tibet, which is often portrayed as linguistically homogenous. A growing body of research now suggests that Tibet is linguistically diverse. In this article, we examine this literature in an attempt to quantify Tibet's linguistic diversity. We focus on the minority languages of Tibet—languages that are neither Chinese nor Tibetan. We provide five different estimates of how many minority languages are spoken in Tibet. We also interrogate these sources for clues about language endangerment among Tibet's minority languages and propose a sociolinguistic categorization of Tibet's minority languages that enables broad patterns of language endangerment to be perceived. Appendices include lists of the languages identified in each of our five estimates, along with references to key sources on each language. Our survey found that as many as 60 minority languages may be spoken in Tibet and that the majority of these languages are endangered to some degree. We hope our contribution inspires further research into the predicament of Tibet's minority languages and helps support community efforts to maintain and revitalize these languages.
Objective The efficacy and safety of Compound Kushen Injection (CKI) on advanced colon cancer remain controversial. We undertook a systematic meta-analysis of randomized controlled clinical studies on this issue. Methods A comprehensive literature search was conducted by searching the following electronic databases: PubMed, Cochrane, Chinese Biological Medical disc, Chinese National Knowledge Infrastructure, and Wan-Fang Database in China by the end of January 31, 2017, without language restriction. Meta-analysis was performed by using the random effects model to estimate the summary odd ratio (OR) with 95% confidence interval (CI) according to the study design. Stata 12.0 software was used for data analysis. The heterogeneity, sensitivity, and publication bias were assessed, respectively. Results A total of 14 trials met the inclusion criteria in present meta-analysis. The results suggested that CKI combined with chemotherapeutic drugs was favorable for the treatment of advanced colon cancer and could improve the patients' life quality. Funnel plot analysis and Egger's test suggested that there was not significant publication bias, and the sensitivity analysis indicated stable results. Conclusion The current evidence suggested that CKI is favorable to improve the efficacy of chemotherapeutic drugs in patients with advanced colon cancer.
This article explores a small (14 cm×7 cm×1.5 cm) Mongolian manuscript package. The package consists of several manuscripts as follows: 1. incense offering to the Five Personal Protectors (tib. 'go ba'i lha lnga); 2. Diamond sutra; 3. two printed amulets (with Tibetan scripts); 4. a drawing (with Tibetan text on the backside); 5. some pieces of paper with astrological content. We can divide these texts into three parts: protectors, blessers and astrological manuals. The protectors are the offering to the Five Personal Protectors and the amulets. The blesser is the Diamond sutra, which has beneficial effect to the reader or the holder of the manuscript. This manuscript has a colophon that states it was written (or copied) in 1914. The astrological manuals are on different pages that seem to have been used more than the others (the sheets indicate frequent use). In this article, the offering to the Five Personal Protectors is transcribed and translated, the description of the amulets is given and one part of the astrological manual is also presented.
OBJECTIVE To systematically evaluate the curative clinical efficacy and safety of sinomenine (SIN) in treatment of rheumatoid arthritis (RA) in comparison to methotrexate (MTX). METHODS We searched the China National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, China Science and Technology Journal Database, Wanfang Database, Pubmed and Cochrane Library electronically up to August 31, 2015, without language limitation. Only randomized controlled trials (RCTs) were included. Software Review Manager 5.3 was used for Meta-analysis. RESULTS A total of 16 eligible studies within 1500 RA patients were included. The meta-analysis indicated that on basis of MTX, SIN was more effective in total effective rate (P < 0.000 01). Besides, SIN alone versus MTX also showed advantages in RA therapy (P = 0.04) Taken together, adverse events occurred less frequently in combination of SIN and MTX than MTX alone (P < 0.0001), especially in digestive system (P < 0.000 01),while occurred more in dermato mucosal system with SIN treatment versus MTX (P = 0.02), and were similar for both remedies in nervous system (P = 0.12) and hematological system (P = 0.25). CONCLUTION Compared to MTX, SIN had better clinical efficacy and relatively fewer adverse events in treatment of RA, especially when it was used together with MTX. Due to the poor methodological quality, well-designed, multiple-center RCTs are still required to further confirm the findings.