BackgroundPatients with depressive disorder often exhibit impaired decision-making functions. However， the relationship between decision-making abilities and depressive and anxiety symptoms in these patients remains unclear. ObjectiveTo explore the characteristics of decision-making behavior in patients with depressive disorder， and to analyze its relationship with clinical symptoms. MethodsA total of 48 patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） were recruited from the Department of Psychosomatic Medicine of the Affiliated Hospital of Southwest Medical University from October 2020 to May 2023. Concurrently， 52 healthy individuals matched for age and gender were recruited from Luzhou as the control group. Beck Depression Inventory （BDI） and Beck Anxiety Inventory （BAI） were used for assessment， and decision-making behavior was evaluated using Probabilistic Reversal Learning （PRL） task. Indicators assessed included the number of trials to criterion， perseverative errors， win-stay rate and lose-shift rate. Spearman correlation analysis was used to assess the correlation between BDI and BAI scores and PRL task indicators. ResultsThe depression group showed a significantly higher lose-shift rate compared with the control group （t=3.684， P<0.01）. There were no statistically significant differences between two groups in trials to criterion， perseverative errors and win-stay rate （t=0.329， 0.132， 0.609， P>0.05）. In depression group， BDI and BAI scores were positively correlated with the win-stay rate（r=0.450， 0.398， P<0.01）. ConclusionPatients with depressive disorder are more likely to change their decision-making strategies following negative outcomes. Furthermore， the severity of depressive and anxiety symptoms is associated with a greater propensity to maintain existing decisions after receiving positive feedback. ［Funded by 2019 Joint Project of Luzhou Science and Technology Bureau-Southwest Medical University （number， 2019LZXNYDJ39］

ObjectiveStudies have shown that nuciferine has anti-cerebral ischemia effect， but the specific mechanism of action has not been elaborated. Based on the transcriptome results， the pharmacological mechanism of nuciferine against cerebral ischemia was analyzed from multiple dimensions including tissue， cell， pathological process， biological process and signaling pathway. MethodsThirty SD rats were randomly divided into the sham group， model group and nuciferine group（40 mg·kg^-1） according to weight. Except for the sham group， the model of middle cerebral artery occlusion（MCAO） was established by thread embolization method after 30 min of administration in the other two groups. Twenty-four hours after surgery， transcriptome sequencing was used to detect the gene expression profiles in the cortex penumbra of rat cerebral tissue， and gene ontology（GO） and kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment analysis were performed for differentially expressed genes. The mechanismof nuciferine against cerebral ischemia was analyzed from 5 dimensions of tissue， cell， pathological process， biological process and signaling pathway by the transcriptome-based multi-scale network pharmacology platform（TMNP）. ResultsTranscriptome sequencing and gene quantitative analysis showed that 667 genes were significantly reversed by nuciferine. Further enrichment analysis of KEGG and GO suggested that the pathways of nuciferine involved regulating stress response， ion transport， cell proliferation and differentiation， and synaptic function. TMNP research found that at the tissue level， nuciferine could significantly improve the cerebral tissue injury caused by ischemia. At the cellular and pathological levels， nuciferine could play an anti-cerebral ischemia role by improving the state of various nerve cells， mobilizing immune cells， regulating inflammation. And at the level of biological processes and signaling pathways， nuciferine mainly acted on the processes such as vascular remodeling， inflammation-related signaling pathways， and synaptic signaling. ConclusionCombined with the results of transcriptome sequencing， gene quantitative analysis and TMNP， the mechanism of nuciferine against cerebral ischemia may be related to processes such as intervening in stress response and inflammation， affecting vascular remodeling and regulating synaptic function. These results can provide a basis and reference for further study of the pharmacological mechanism of nuciferine against cerebral ischemia.

Objective:To investigate the clinical characteristics of omphalocele, and to assess the risk factors associated with adverse outcomes.Methods:A retrospective cohort study was conducted. Clinical data of 224 patients diagnosed with omphalocele, who were hospitalized at Children′s Hospital, Zhejiang University School of Medicine from January 2013 to December 2022, were collected. Based on their discharge outcomes, the patients were classified into 2 groups: favorable outcomes and unfavorable outcomes. Chi-square test or continuity correction χ2 test or Fisher exact probability method, and Mann-Whitney U test were used for intergroup comparisons. Logistic regression analysis was performed to identify risk factors associated with adverse outcomes in omphalocele. Results:Among the 224 patients with omphalocele, 126 were male. A total of 208 patients (92.9%) had favorable outcomes, while 16 patients (7.1%) had unfavorable outcomes. In the unfavorable outcomes group, 14 patients had giant omphaloceles, while 100 patients had giant omphaloceles in the favorable outcomes group. The rates of herniation of more than two intra-abdominal organs in the hernial sac, congenital heart defects, patent ductus arteriosus, pulmonary hypertension, sepsis and infection of the hernial sac, were all higher in the unfavorable outcomes group compared to the favorable outcomes group (all P<0.05). Patients with unfavorable outcomes had longer mechanical ventilation time, duration of oxygen use, duration of parenteral nutrition, hospital stays, and higher rates of parenteral nutrition-associated cholestasis compared to those with favorable outcomes (all P<0.01). Multivariate Logistic regression analysis indicated that pulmonary hypertension ( OR=9.39, 95% CI 1.20-73.32), sepsis ( OR=8.59, 95% CI 1.32-55.86), and congenital heart defects ( OR=6.55, 95% CI 1.11-38.73) were all independent risk factors for adverse outcomes in omphalocele (all P<0.05). Conclusions:Infants with omphalocele are prone to complications such as cardiovascular malformations, infections, and pulmonary hypertension. Adverse outcomes in omphalocele are associated with pulmonary hypertension, sepsis, and congenital heart defects.

Epigenetic pathways play a critical role in the initiation, progression, and metastasis of cancer. Over the past few decades, significant progress has been made in the development of targeted epigenetic modulators (e.g., inhibitors). However, epigenetic inhibitors have faced multiple challenges, including limited clinical efficacy, toxicities, lack of subtype selectivity, and drug resistance. As a result, the design of new epigenetic modulators (e.g., degraders) such as PROTACs, molecular glue, and hydrophobic tagging (HyT) degraders has garnered significant attention from both academia and pharmaceutical industry, and numerous epigenetic degraders have been discovered in the past decade. In this review, we aim to provide an in-depth illustration of new degrading strategies (2017-2023) targeting epigenetic proteins for cancer therapy, focusing on the rational design, pharmacodynamics, pharmacokinetics, clinical status, and crystal structure information of these degraders. Importantly, we also provide deep insights into the potential challenges and corresponding remedies of this approach to drug design and development. Overall, we hope this review will offer a better mechanistic understanding and serve as a useful guide for the development of emerging epigenetic-targeting degraders.

Objective To establish and forensically verify a 42 microhaplotypes(mircohaps,MHs)mul-tiplex assay system based on next-generation sequencing(NGS),and to explore the application value of this system in the practice of forensic genetics.Methods A total of 42 highly polymorphic MHs were selected from previous studies,and sequenced by the MiSeq FGxTM platform to verify the repeata-bility,sensitivity,specificity,stability,and mixture analysis ability of the detection system.Through population genetic investigation of 102 unrelated Chinese Han individuals in Liyang City,Jiangsu Province,China,the application value of this system in forensic genetics was evaluated.Results The sequencing repeatability of the 42-plex MHs assay was 100%and the sensitivity was as low as 0.062 5 ng.The system had the ability to withstand the interference of indigo(≤2 500 ng/μL),humic acid(≤9 ng/μL),hemoglobin(≤20 μmol),and urea(≤200 ng/μL)and to detect mixtures of 2 people(1∶19),3 people(1∶1∶9)and 4 people(1∶1∶1∶9).Based on 102 individual data,the combined power of discrimination and the combined power of exclusion were 1-3.45×10-30 and 1-3.77×10-11,respectively,and the average effect value of alleles was 2.899.Conclusion The 42-plex MHs assay was successfully established in this study and this system has high repeatability and sensitivity,good anti-jamming ability and mixture analysis ability.The 42 MHs are highly polymorphism and have good application value in individual identification and paternity testing.

Objective To explore the comparative application of phase and diaphragmatic navigation in three-dimensional magnetic resonance cholangiopancreatography(3D-MRCP)thin-layer scanning in elderly patients.Methods A total of 180 elderly patients were scanned by phase and diaphragmatic navigation via Siemens Aera1.5T superconducting MR scanner.The acquired images were reconstructed by 3D reconstruction.The anatomical structure,image quality and disease diagnosis were compared between the phase and diaphragmatic navigation groups.Results In liver of anatomy,the liver of primary bile duct,the superior,middle and inferior extrahepatic bile duct and the gallbladder could be well displayed,and the difference was not statistically significant between the two groups(P＞0.05).The display of pancreatic duct and the liver of secondary bile duct of diaphragmatic navigation was significantly better than those of phase navigation(P＜0.05).In terms of image quality,the excellent rate of diaphragmatic navigation was significantly higher than that of phase navigation,and the difference was statistically significant(P＜0.05).There were no statistically significant differences in the detection rate of pancreatobiliary system diseases,the diagnostic rate of cholelithiasis,common bile duct stones,common bile duct dilatation and pancreatic duct dilatation between the two groups(P＞0.05).Conclusion Diaphragmatic navigation is signifi-cantly better than phase navigation in the display of the anatomical structure of the pancreatic duct,the liver of secondary bile duct,and the excellent rate of image quality.Diaphragmatic navigation is more suitable for thin-layer 3D-MRCP scanning in elderly patients.

BACKGROUND:A large number of studies have investigated the effects of whole body vibration training at different frequencies on muscle strength,but less is reported on the differences in the efficacy of vibration training at different frequencies on patellar tendinopathy. OBJECTIVE:To explore the effect of eccentric training of quadriceps combined with different frequency of whole body vibration training on patellar tendinopathy. METHODS:From April to June 2022,48 patients with patellar tendinopathy were recruited from Wuhan Sports University and randomly divided into eccentric training group(n=12),30 Hz group(n=12),40 Hz group(n=12),and 50 Hz group(n=12).The eccentric training group only completed eccentric training of the quadriceps.The 30 Hz,40 Hz and 50 Hz groups performed the whole body vibration training with the amplitude of 2 mm and frequencies of 30 Hz,40 Hz and 50 Hz respectively on the basis of the eccentric training of the quadriceps.The intervention lasted for 8 weeks,three times a week.Before and after the intervention,the patients'surface electromyography signals of the quadriceps,kinematics and dynamics data of knee joint at the time of landing in deep jump and the time of peak vertical ground reaction,Visual Analogue Scale score,Victorian Institute of Sports Assessment-Patellar score were evaluated. RESULTS AND CONCLUSION:After 8 weeks of intervention,compared with the eccentric training group,the median frequency of the lateral and medial femoris muscles were significantly higher in the 40 Hz and 50 Hz groups(P＜0.05).At the time of landing,the knee joint flexion angle and external rotation moment in the 40 Hz and 50 Hz groups were significantly lower than those in the eccentric training group(P＜0.05),while the knee joint flexion angle in the 50 Hz group was significantly lower than that in the 30 Hz group(P＜0.05).At the peak moment of vertical ground reaction,the knee extension torque in the 40 Hz group was significantly lower than that in the eccectric training group(P＜0.05);the knee flexion angle and knee extension torque in the 50 Hz group were significantly lower than those in the eccentric training group(P＜0.05).The Visual Analogue Scale scores in the 50 Hz and 40 Hz groups were significantly lower than those in the eccentric training group(P＜0.05).The Victorian Institute of Sports Assessment-Patellar score in the 50 Hz group was significantly higher than that in the eccentric training group and 30 Hz group(P＜0.05).To conclude,eccentric training of the quadriceps combined with 50 Hz whole body vibration training can significantly improve quadriceps'strength,endurance and activation rate of the vastus lateralis muscle,reduce the pain of knee joint,and improve the function of the knee joint in patients with patellar tendinopathy.

OBJECTIVE:Some studies have shown that kinesio taping has positive effects in elevating muscle strength,improving joint stability and reducing pain and oedema in patients after anterior cruciate ligament reconstruction.However,existing studies have divergent results on the clinical efficacy of kinesio taping.In this study,a meta-analysis was conducted to systematically evaluate the effect of kinesio taping in postoperative rehabilitation period following anterior cruciate ligament reconstruction. METHODS:Randomized controlled trials about the effects of kinesio taping on anterior cruciate ligament reconstruction were electronically searched in PubMed,Web of Science,Embase,The Cochrane Library,EBSCO,CNKI,WanFang,and VIP databases,from database inception to December 06,2022.The outcome measures included six continuous variables:quadriceps strength,hamstring strength,knee swelling,knee range of motion,Lysholm knee function score,and Visual Analogue Scale score.EndNote X9.1 was used to screen the literature.The Cochrane Risk Bias Assessment Tool and Jadad Scale were used to evaluate the quality of the included literature.RevMan 5.3 software was used for Meta-analysis. RESULTS:A total of 6 randomized controlled trials involving 252 patients undergoing anterior cruciate ligament reconstruction were finally included.There were 126 cases in control group and 126 in kinesio taping group.The results of Meta-analysis showed that compared with the control group,kinesio taping significantly improved hamstring strength[standardized mean difference(SMD)=0.68,95%confidence interval(CI):0.12 to 1.23,P=0.02)and reduced Visual Analogue Scale score[mean difference(MD)=-0.56,95%CI:-1.04 to-0.08,P=0.02).However,for quadriceps strength,knee swelling,knee range of motion,and Lysholm knee function score,kinesio taping did not show significant difference from the control group(P＞0.05). CONCLUSION:Kinesio taping may help to improve hamstring strength and reduce pain in patients after anterior cruciate ligament reconstruction.However,it cannot significantly improve quadriceps strength,knee swelling,knee range of motion,and functional scores.

BACKGROUND:At present,postoperative timing or subjective criteria by clinicians are commonly employed to determine the return-to-sport timing for patients undergoing anterior cruciate ligament reconstruction.Unfortunately,these criteria do not adequately consider the biomechanical deficits in patients following anterior cruciate ligament reconstruction. OBJECTIVE:To explore the lower extremity kinematic and kinetic characteristics of athletes after anterior cruciate ligament reconstruction during bilateral vertical jumping. METHODS:Twenty athletes undergoing anterior cruciate ligament reconstruction and twenty healthy athletes,aged 20-24 years,were recruited in Wuhan Sports University from December 2021 to December 2022.All the 40 subjects underwent a bilateral vertical jumping test.The kinematic and dynamic characteristics of the lower limbs at propulsion phase,initial landing time and peak vertical ground reaction force moment. RESULTS AND CONCLUSION:At the initial landing time,the athletes undergoing anterior cruciate ligament reconstruction showed higher hip flexion angle(P=0.031)and lower ankle plantar flexion angle(P=0.018)on the operated side compared with the healthy athletes.At the peak vertical ground reaction force moment,the athletes undergoing anterior cruciate ligament reconstruction had higher hip flexion angle(P=0.016),lower hip abduction angle(P=0.019),lower knee flexion angle(P=0.025),higher knee external rotation angle(P=0.030),and higher ankle external rotation angle(P=0.042)on the operated side compared with the healthy athletes.At the peak vertical ground reaction force moment,the athletes undergoing anterior cruciate ligament reconstruction showed lower knee extension moment(P=0.036),lower knee internal rotation moment(P=0.016),lower hip abduction moment(P=0.004),higher hip extension moment(P=0.040),and higher hip external rotation moment(P=0.005)on the operated side compared with the healthy athletes.To conclude,the athletes undergoing anterior cruciate ligament reconstruction exhibit a stiff landing pattern,in which the knee load on the operated side tends to shift to the hip joint,and show inadequate control of lower limb rotational stability.Therefore,detection and correction of abnormal biomechanical characteristics should be part of the rehabilitation after anterior cruciate ligament reconstruction.

BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning. DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources. RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is difficult to treat,and there is no specific antidote. CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease.