Objective:To develop a risk prediction model for the recurrence of diabetic foot ulcer (DFU) in diabetic patients and primarily validate its predictive value.Methods:Meta-analysis combined with retrospective cohort study was conducted. The Chinese and English papers on risk factors related to DFU recurrence publicly published in China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and PubMed, Embase, Cochrane Library, and Web of Science, and the search time was from the establishment date of each database until March 31 st, 2022. The papers were screened and evaluated, the data were extracted, a meta-analysis was performed using RevMan 5.4.1 statistical software to screen risk factors for DFU recurrence, and Egger's linear regression was used to assess the publication bias of the study results. Risk factors for DFU recurrence mentioned in ≥3 studies and with statistically significant differences in the meta-analysis were selected as the independent variables to develop a logistic regression model for risk prediction of DFU recurrence. The medical records of 101 patients with DFU who met the inclusion criteria and were admitted to Affiliated Hospital of Guizhou Medical University from January 2019 to June 2022 were collected. There were 69 males and 32 females, aged (63±14) years. The receiver operating characteristic (ROC) curve of the predictive performance of the above constructed predictive model for DFU recurrence was drawn, and the area under the ROC curve, maximum Youden index, and sensitivity and specificity at the point were calculated. Dataset including data of 8 risk factors for DFU recurrence and the DFU recurrence rates of 10 000 cases was simulated using RStudio software and a scatter plot was drawn to determine two probabilities for risk division of DFU recurrence. Using the β coefficients corresponding to 8 DFU recurrence risk factors ×10 and taking the integer as the score of coefficient weight of each risk factor, the total score was obtained by summing up, and the cutoff scores for risk level division were calculated based on the total score × two probabilities for risk division of DFU recurrence. Results:Finally, 20 papers were included, including 3 case-control studies and 17 cohort studies, with a total of 4 238 cases and DFU recurrence rate of 22.7% to 71.2%. Meta-analysis showed that glycosylated hemoglobin >7.5% and with plantar ulcer, diabetic peripheral neuropathy, diabetic peripheral vascular disease, smoking, osteomyelitis, history of amputation/toe amputation, and multidrug-resistant bacterial infection were risk factors for the recurrence of DFU (with odds ratios of 3.27, 3.66, 4.05, 3.94, 1.98, 7.17, 11.96, 3.61, 95% confidence intervals of 2.79-3.84, 2.06-6.50, 2.50-6.58, 2.65-5.84, 1.65-2.38, 2.29-22.47, 4.60-31.14, 3.13-4.17, respectively, P<0.05). There were no statistically significant differences in publication biases of diabetic peripheral neuropathy, diabetic peripheral vascular disease, glycosylated hemoglobin >7.5%, plantar ulcer, smoking, multidrug-resistant bacterial infection, or osteomyelitis ( P>0.05), but there was a statistically significant difference in the publication bias of amputation/toe amputation ( t=-30.39, P<0.05). The area under the ROC curve of the predictive model was 0.81 (with 95% confidence interval of 0.71-0.91) and the maximum Youden index was 0.59, at which the sensitivity was 72% and the specificity was 86%. Ultimately, 29.0% and 44.8% were identified respectively as the cutoff for dividing the probability of low risk and medium risk, and medium risk and high risk for DFU recurrence, while the corresponding total scores of low, medium, and high risks of DFU recurrence were <37, 37-57, and 58-118, respectively. Conclusions:Eight risk factors for DFU recurrence are screened through meta-analysis and the risk prediction model for DFU recurrence is developed, which has moderate predictive accuracy and can provide guidance for healthcare workers to take interventions for patient with DFU recurrence risk.

【Objective】 To observe the characteristics and correlation analysis of thromboelastogram (TEG) and platelet related indexes in patients with preeclampsia in late pregnancy. 【Methods】 88 patients with preeclampsia in late pregnancy treated in the Obstetrics Department of Shanghai Ninth People′s Hospital (Northern Hospital) from June 2017 to June 2020 were selected as observation group, and 288 normal pregnant women in late pregnancy with normal prenatal examination were selected as the control. The median elbow vein blood of the two groups were sampled. The TEG and coagulation related indexes of the two groups were compared, and the relationship between TEG and coagulation related indexes in patients with preeclampsia were analyzed. 【Results】 The K, MA, TT, INR and PLT value in the observation group, relative to controls, were significantly higher (P<0.01), but Angle, PT, and APTT value were significantly lower (P<0.01). The variance K and MA were negatively correlated with PT and APTT (P<0.05), but positively correlated with TT, INR and Plt (P<0.05). Angle was positively correlated with PT and APTT (P<0.05), but negatively correlated with TT, INR and Plt(P<0.05). 【Conclusion】 Routine TEG detection can effectively evaluate the coagulation state of patients with preeclampsia, who are often accompanied by coagulation dysfunction, help to guide clinical early prevention and intervention, and reduce the risk of perinatal hemorrhage and embolism diseases, which is worthy of popularizing in clinical.

Objective:To determine initial concentrations of ozonated water under different temperatures,attenuation rules ofozonated water under the room temperature (25 ℃),and to inspect the effects ofozonated water under different concentrations on common microorganisms.Methods:The online test method and the plate cultivation method were employed to check the concentrations and killing rates on common microorganisms of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument.Results:The initial concentrations of ozonated water at 20,25,30,35,and 40 ℃ were 4.38,4.26,3.12,2.76,and 1.31 mg/L,respectively.The ozonated water was rapidly attenuated at first 10 min.The concentration ofozonated water still remained at 1.06 mg/L and 0.37 mg/L at 25 and 30 ℃ after 30 min.The average killing rates for Pseudornonas aeruginosa,Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,and Candida albicans in 1.0 mg/L ozonated water for 1 min were 99％,100％,100％,100％,and 100％,respectively.The average killing rates of Escherichia coli,Staphylococcus aureus,methicillin-resistant Staphylococcus aureus,Pseudomonas aeruginosa,and Candida albicans in 0.3 mg/L ozonated water for 1 min were 100％,100％,100％,95％,and 92％,respectively.Conclusion:The initial concentrations of ozonated water produced by HZ-2601 B Ozone Water Generating Instrument decrease with the increase of temperature.Ozonated water under 20-30 ℃ has good sterilization effect on common microorganisms.

Objective:To verify the effect of ozone on Staphylococcus aureus (S.aureus) colonization in patients with atopic dermatitis (AD) and its correlation with the patient's status.Methods:A total of 12 patients with moderate or severe AD,aged from 6 to 65 years,were recruited from outpatient of the Third Xiangya Hospital.The treatment sides were showered with ozonated water and smeared with ozonated oil for 7 days (twice a day),while the control sides were washed with warm running water and smeared with base oil.At different time points,the severity scoring ofatopic dermatitis (SCORAD) scores,sleep and pruritus scores were assessed and compared between the two sides.Meanwhile,plate cultivation was used to quantitatively detect the changes ofS.aureus colonization in skin lesions.Results:After 7 days treatment,erythema and pimples were decreased in the treatment sides.The clear skin texture,smooth skin,improved skin lesions were also observed by dermoscopic examination.The results of reflectance confocal microscopy (RCM) demonstrated that the parakeratosis was improved,the structures were clearer,and the inflammatory cells infiltration was reduced after ozone treatment for 7 days.After ozone treatment for 3 and 7 days,the S.aureus colonization in the treatment sides decreased by (75.55±21.81)％ and (97.24±2.64)％ respectively.Compared to that of control sides,the percentage of S.aureus colony after ozone treatment for 7 days decreased significantly (P＜0.01).After ozone treatment for 7 days,the SCORAD scores,sleep and pruritus scores were significantly decreased (all P＜0.01).There was a linear correlation between the decreasing percentage of S.aureus colony and the declining percentage of SCORAD scores in AD patients.Conclusion:Topical ozone therapy can effectively reduce S.aureus colony in skin lesions and alleviate the severity of AD patients with moderate to severe degree.

Objective:To evaluate the clinical efficacy and safety of the innovative topical ozone therapy for infantile atopic dermatitis.Methods:Sixty children with atopic dermatitis were divided into a treatment group and a control group.The treatment group was showered with ozonated water (3-5 times a week) and smeared with ozonated oil (twice a day),while the control group was washed with warm running water and smeared with base oil,adding moisturizer if necessary.The treatment course was 2 weeks.Efficacy and side effect were evaluated.Results:The skin exudation was reduced and erosion was healing after 3-5 days topical ozone therapy for infantile atopic dermatitis.The effective rates were 80.0％ and 20.0％ in the treatment group and control group for 1 week,and 89.6％ and 30.7％ for 2 weeks,respectively,with significant difference between the 2 groups (P＜0.001).Conclusion:Innovative treatment of infantile atopic dermatitis with topical ozone application is safe and effective,which is worth popularizing in clinic.

Objective:To observe the clinical efficacy and safety of topical ozone therapy for patients with herpes zoster by reflectance confocal microscopy (RCM).Methods:A total of 60 patients with herpes zoster were divided into a control group and an ozone treatment group (n=30).In the control group,patients took oral valacyclovir tablets or granules (0.3 g per day,three times a day) and they were subjected to local weak laser irradiation treatment plustopical 2％ mupirocin ointment twice a day.In the ozone group,the treatment is same as the control group except mupirocin ointment was replaced with topical ozone treatment (hydrotherapy every day plus ozonated oil twice a day).The clinical symptoms,discoid cell and adverse reactions were observed and taken records at day 0,3,7 and 14.Statistical analysis was performed to compare the clinical efficacy between the 2 groups.Results:On the seventh day of treatment,the discoid cells of the ozone group disappeared,and the difference between the control group and the ozone group was statistically significant (P＜0.05).The difference of decreased percentage of pain scores at each time point between the 2 groups was statistically significant (P＜0.05).The clinical efficacy was 100％ in the ozone group and 86.7％ in the control group,with significant difference between the 2 groups (P＜0.05).Conclusion:Topical ozone therapy in patients with herpes zoster is helpful in relieving pain,shortening the course as well as improving the clinical efficacy without obvious adverse reactions.It is worth to be popularized.

Objective To explore the potential role and function of miR-30 a in myocardial fibrosis after myocardi-al infarction( MI) .Methods We constructed the AAV plasmid vector which carried the miR-30 a gene of rat.The recombinant plasmid was detected by gene sequencing , enzyme digestion and PCR .Virus was packaged into HEK293 cells and virus titer was determined after extraction and purification by PCR .PBS fluid, rAAV9-miR-30 a-NC and rAAV9-miR-30 a were transmited to rat hearts from PBS group , miR-30 a-NC group and miR-30 a group respectively through transcoronary infusion before anterior descending coronary artery ligation .Sham group was set up at the same time.After 4 weeks, heart function was monitored by serial echocardiography , including fractional shortening ( FS) , and left ventricular ejection fraction ( LVEF) .Masson staining was used to calculate collagen volume fraction ( CVF) .The expression of collagen ⅠandⅢwere detected by immunohistochemistry . The mRNA level of miR-30a, TGF-β1 and CTGF were detected by real-time PCR.The protein level of TGF-β1 and CTGF were detected by western blot analysis .Results The cardiac function of miR-30 a group was improved significantly compared with PBS group and miR-30a-NC group (P<0.05).The levels of CVF,collagenⅠ,Ⅲexpression and Collagen Ⅰ/Ⅲ ratio in miR-30 a group was significantly lower than PBS group and miR-30 a-NC group ( P<0.01 ) .The mRNA and protein level of TGF-β1 and CTGF in miR-30 a group were reduced signifi-cantly than PBS group and miR-30 a-NC group ( P<0.001 ) .Conclusions The overexpression of miR-30 a after MI may reduce the mRNA and protein level of TGF-β1 and CTGF, so as to suppress myocardial fibrosis and im-prove cardiac function.

OBJECTIVEThis study investigated the reconstructed mandibular condylar cartilage and the ultrastructural variations in mandibular condylar cartilage in adult rats as a result of mandibular advancement.

METHODSThirty 9-week-old male Sprague-Dawley rats were randomly divided into experimental and control groups. Rats in the experimental group were subjected to mandibular advancement. Rats were sacrificed on days 3, 7, 14, 21, 30. Sections were cut from condyles, and bone morphogenetic protein-2 (BMP-2) expression in condylar cartilage was examined through immunohistochemical analysis. Condylar cartilage samples were harvested, and ultrastructural changes in these samples were observed under Micro-CT and transmission electron microscope.

RESULTSCompared with the control group, the experimental group obviously displayed cartilage hyperplasia in the middle and rear of the condyle. Moreover, the number of BMP-2-positive cells in condylar cartilage and the gray value gradually increased in the experimental group on day 7 of the intervention. Ultrastructural changes, such as karyopyknosis, reduced microfilaments around the nucleus, reduction in size or even disappearance of lipid droplets, swelling of endoplasmic reticulum compartments, broadened and increased extracellular matrix, were observed in the condylar hypertrophic chondrocytes. Micro-CT revealed that the trabecula and the newly formed bone gradually thickened.

CONCLUSIONSHypertrophic remodeling of the condylar cartilage and high BMP-2 expression are observed in adult rats as a result of continuous mandibular advancement.

Objective To evaluate the clinical diagnosis,treatment and prognostic factors of kidney clear cell renal carcinoma(KIRC)in international sample database.Methods From 1998 to 2012,consecutive patients with KIRC who diagnosed and treated in TCGA organizations were enrolled.Clinical characteristics,objective response and survival time were evaluated,and correlation analysis with lncRNA urothelial cancer associated 1 (UCA1)gene was performed.Results 512 patients with KIRC were enrolled.35.4% of patients were female,59.6% of stage Ⅰ -Ⅱ, 90.0% of white and 45.1% of grade 1 -2.Comprehensive treatment was consistent with the clinical guidelines. Significant correlation was found between UCA1 expression and 4 mRNA subtype,30 genes mRNA expression, mir -101 -1 expression and PBRM1 mutation.And patients with UCA1 overexpression could achieve poor prognosis. Conclusion Diagnosis and treatment of the international TCGA -KIRC research meets clinical guidelines.UCA1 overexpression is an important poor prognostic factor.Combined with the clinical relevance of other important driver genes,UCA1 may be significantly valuable for further study.

To introduce the application of CBL teaching method on neuroanatomy teaching in undergraduate of con -tinue education school .Cases selection and reconstruction , designing problems , organization , implementation and standardized teaching were analyzed .Finally, we discussed the advantages and disadvantages of CBL teaching method.