Objective:To explore the brain activation intensity changes of depressed patients in the phase of expected value (EV), positive prediction error (+ PE) and negative prediction error (-PE) under uncertain (risky, ambiguous) decision-making.Methods:From July 2018 to February 2021, a total of 48 depressed patients in the Affiliated Hospital of Qingdao University were collected (depression group), and 69 sex-, age-, and educational level-matched healthy people were recruited as the control group. All participants completed risky and ambiguous decision-making tasks under the E-Prime system.SA-9800 brain functional audio-visual stimulation system and GE3.0 T functional magnetic resonance imaging (fMRI) scanners were used to conduct synchronous scanning and data acquisition. Using Xjview software to analyze the activation intensity of related brain areas to compare the activity intensity of the two groups.SPSS 16.0 software was used for chi square test, independent sample t-test. Results:Under risky decision-making, compared with the control group, the brain areas with reduced activation during EV phase in depression group were bilateral prefrontal cortex (PFC)(MNI coordinate: left x=-45, y=21, z=-6; right x=0, y=69, z=-3), left para hippocampal gyrus(PHG)(MNI coordinate: x=-9, y=0, z=-22), bilateral occipital lobe(OL)(MNI coordinate: left x=-51, y=-81, z=-3; right x=48, y=-84, z=-9)( P<0.05). The brain areas with reduced activation during + PE phase were bilateral PFC, left hippocampus (HIP), bilateral temporal lobe (TL), left middle occipital gyrus( P<0.05). The brain areas with reduced activation were bilateral PFC, right putamen, bilateral TL( P<0.05) during -PE phase. Under ambiguous decision-making, compared with the control group, the brain areas with reduced activation during EV phase in depression group were bilateral PFC, right OL( P<0.05); the brain areas with reduced activation during + PE phase were bilateral PFC, right putamen and hippocampus, bilateral TL, bilateral OL( P<0.05); and the brain areas with reduced activation were bilateral PFC, bilateral TL( P<0.05) during -PE phase. Conclusion:The study shows that the activities of reward brain areas such as PFC, limbic system and OL system are reduced during EV and PE phase under uncertain decision-making in depressed patients.

Objective To analyze the changes of antibody levels in positive patients with epidemic hemorrhagic fever(EHF) in Dongwan, and to provide effective theoretical guidance for the prevention . Methods From January 2018 to April 2022, the antibody test and general sociological characteristics, such as age, sex, occupation of 153 patients who were confirmed to be positive for serum EHF antibody by establishing infectious disease report cards were collected. Statistical analysis was performed using t test and 2test. Results Among of 153 patients , 70 were IgG positive, and the antibody positive rate was 45.75%. There was no significant difference in IgG antibody positive rate between EHF patients of different gender（χ²=0.165，P=0.685）. Commercial services (76.90%), workers (34.10%), unemployed or retired (44.10%) had the highest antibody positive rate. The IgG positive rate of EHF patients in different age groups was different. The antibody positive rate was the highest in the age group of 25-35 years old, and the antibody positive rate was lower in the age group of 60 years old and later. Among the 153 patients, the IgG antibody positive rate of the patients with onset in December, January and February was the highest, reaching 60.71% and 66.67% respectively. The IgG antibody positive rate of the patients with onset in April September was lower（ χ²=14.366，P=0.021）. Conclusion The positive rate of IgG antibody in EHF patients in Dongguan was high, which was related to occupation, age and time of onset; It is necessary to strengthen vaccination for this group of people to improve the antibody immunity level.

Objective:To summarize the best evidence on exercise for the prevention and treatment of diabetic foot.Methods:A bibliometric approach was used. Systematic searches were carried out to retrieve all the publicly published evidences till July 2022 on exercise for the prevention and treatment of diabetic foot, including guidelines, evidence summary, recommended practices, expert consensus, systematic review, and original research, from foreign language databases including BMJ Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Practice Database, Cochrane Library, Embase, PubMed, Guideline International Network, National Guideline Clearinghouse, Chinese databases including China National Knowledge Infrastructure, Wanfang Database, VIP Database, China Biology Medicine disc, China Clinical Guidelines Library, and the official websites of relevant academic organizations including National Institute for Health and Care Excellence of the United Kingdom, Registered Nurses' Association of Ontario of Canada, the International Working Group on the Diabetic Foot, International Diabetes Federation, American College of Sports Medicine, American Diabetes Association, and Chinese Diabetes Society. The literature was screened and evaluated for the quality, from which the evidences were extracted and evaluated to summarize the best evidences.Results:Nine guidelines, three expert consensuses, one evidence summary (with two systematic reviews being traced), two systematic reviews, 6 randomized controlled trials were retrieved and included, with good quality of literature. Totally 33 pieces of best evidences on exercise for the prevention and treatment of diabetic foot were summarized from the aspects of appropriate exercise prevention of diabetic foot, exercise therapy of diabetic foot, precautions for exercise, health education, and establishment of a multidisciplinary limb salvage team.Conclusions:Totally 33 pieces of best evidences on exercise for the prevention and treatment of diabetic foot were summarized from 5 aspects, providing decision-making basis for clinical guidance on exercise practice for patients with diabetic foot.

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 explore the predictive value of serum hypoxia-inducible factor-1α (HIF-1α) and interleukin-6 (IL-6) at admission on short-time 6-month prognosis of patients with severe traumatic brain injury (sTBI). Methods Seventy-two sTBI patients with Glasgow coma score (GCS) 3-8 points in our hospital were selected from September 2016 to January 2018 and divided into the group with good prognosis and group with poor prognosis according to Glasgow outcome score (GOS) after injury 6 months. Serum HIF-1α and IL-6 at admission were detected by using ELISA. The levels of plasma biochemistry indexes, acute physiology and chronic health evaluationⅡ(APACHEⅡ) scores and GCS scores were evaluated. Univariable and Multivariable COX proportional hazards models were performed to analyze the risk factors for short-time prognosis of patients with sTBI. Receiver operating characteristic (ROC) curve was built to analyze the predictive value of APACHEⅡ scores, HIF-1α and IL-6 on short-time prognosis of patients with sTBI. Results After 6-month followed up, there were 33 patients with good prognosis and 39 patients with poor prognosis. There was statistical difference of the baseline values of ages, serum HIF-1α and IL-6 at admission, APACHEⅡscores and GCS scores, the interval from injury to admission, the size of traumatic brain injury between two groups (t=2.312,14.132,16.628,3.172,3.644,3.073,4.284, P＜0.05). The serum HIF-1α [HR (95%CI)=2.645 (1.710-4.679), P＜0.05] and IL-6 [HR(95%CI)=1.821(1.674-2.957), P＜0.05] at admission, APACHEⅡscores [HR(95%CI)=1.789(1.105-2.928), P＜0.05] and the size of traumatic brain injury [HR (95%CI)=6.256 (1.727-10.834), P＜0.05] were the independent influence factors of short-time 6m prognosis of sTBI patients. The area under ROC curve and Youden＇s index of HIF-1α, IL-6 and APACHEⅡscores at admission on prediction of prognosis of sTBI patients were 0.94 (95% CI: 0.81-0.99) and 0.85, which was higher than separate predictive value of HIF-1α, IL-6 and APACHEⅡ scores. Conclusion The present study demontrated that serum HIF-1α and IL-6 at admission may be the early sensitive predictors of short-time prognosis in sTBI patients.

Objective Nowadays ,in the field of stem cell transplantation ,improving the bone mesenchymal stem cells′ability to be implanted into target organs is still a hot topic .Objective of this study is to observe the effects of Naomaiyihao ( NMYH) capsule, a compound traditional Chinese herbal medicine invented for regulating thesea of blood in brain,and survival rate of BMSCs trans-plantaion in cerebral ischemic tissue of rat . Methods 60 rats were randomly divied into 4 group:untreated group ( serum-free L-DMEM +isotonic saline ) , BMSCs transplantation group ( cell suspension+isotonic saline ) , NMYH group ( serum-free L-DMEM+NMYH) and Combination of NMYH and BMSCs group ( cell suspen-sion+NMYH ) .A rat of model of middle cerebral artery occlusion ( MCAO) was established .The third generation BMSCs were isolated and cultured from bone marrow by the holo-bone marrow adherence , the CM-Dil labeled BMSCs were transplanted into corpora striata with stereotactic technique , the rat′s brains were removed and sliced up after 7-,14-and 21-day′transplantation .Then the survival and distribution of cells were observed under the fluorescence microscope . The expression of CD34 in the brain tissue were tested by immunohistochemical method . Results The fluorescence absorbance of combination group was 1.61 ±0.25 on day 14, increased significantly (P<0.05).when compared with BMSCs group (1.23 ±0.17). The fluorescence absorbence of combination group was 0.36 ±0.09 on day 21, increased significantly (P<0.05) when compared with BMSCs group(0.23 ±0.09).Compared with the model group ,numbers of CD34 positive cells on day 7,14 and 21 significantly in-creased in all treated groups(P<0.01).Numbers of CD34 positive cells were significantly more increased(P<0.05) in combination group than those in BMSCs group . Conclusion Survival,distribution and migration trending to boundary regions of ischemia were observed under the fluorescence microscope after transplantation .Naomaoyihao can increase blood supply around the transplanted cell region,and decrease infarct volume .Therefore it could promote BMSCs to better survive in the brain tissue .

Objective To explore therapeutic efficacy of blue-light-filtering intraocular lenses implantation on treating patients with diabetes cataract , and provide a more comfortable choice after phacoemulsification ( PHACO) and intraocularlens ( IOL) implan-tation.Methods A total of 100 cases (100 eyes) of patients with diabetes cataract was collected , and was randomly divided into group I ( n =50, implanted ordinary intraocular lenses ) and group II ( n =50, implanted blue-light-filtering intraocular lenses).Af-ter surgery, the best-corrected vision and postoperative complications were reported .The subjective visual performance was evaluated by questionnaire .Results At 1 week and 1 month after surgery , the best-corrected vision had no significant differences between two groups ( P >0.05 ) .Early complication after surgery was not significantly different between two groups ( P >0.05 ) .The subjective visual performance in the blue-light-filtering intraocular lenses group was significantly better than that in the ordinary intraocular lenses group ( P <0.05 ) .Conclusions When the blood sugar is controlled in certain level , it is possible for the blue-light-filtering in-traocular lenses to provide a better choice for patients with diabetes cataract .

Adolescent ; Adult ; Female ; Humans ; Male ; Neurofibromatoses ; diagnosis ; genetics ; Pedigree

Objective To observe the clinical efficacy and safety of5%imiquimod cream in the top-ical treatment of condyloma acuminatum(CA).Methods A randomized,double-blind,parallel placebo-controlled clinical study was conducted.The test drug was topically used in CA patients,three times a week for8weeks.Patients whose warts cleared completely were followed up for one month to determine recurrence rates.Results Two hundred fifty-eight patients with anogenital warts were enrolled into this trial.One hun-dred twenty-nine patients were randomly selected to receive5%imiquimod cream;129patients were ran-domly chosen to receive placebo cream.Results showed that the cure rates were12.30%,32.79%,50%,60.66%respectively in study group for2,4,6,8weeks and were4.88%,14.63%,19.51%,26.02%respec-tively in control group for2,4,6,8weeks(P

Objective To evaluate the effectiveness and safety of implantation of flexible open-loop anterior chamber intraocular lens (FOAC-IOLs) and scleral fixated posterior chamber intraocular lens (PC-IOLs).Methods Sixty-eight eyes of 68 patients with implanted intraocular lenses in the absence of posterior capsular support were reviewed retrospectively. According to the type of intraocular lens, patients were classified into two groups. In groupⅠ (30 eyes), FOAC-IOLs was implanted primarily or secondarily. In group Ⅱ (38 eyes), scleral fixated PC-IOLs was implanted primarily or secondarily. By gonioscopy and ultrasound biomicroscopy (UBM), accurate positions of IOLs' haptics and the relationship between the haptics and surrounding tissues were observed postoperatively and used to evaluate the influence of the two types of IOLs on ocular anterior segments. Follow-up was 6 to 20 months. Results Best corrected visual acuity of 20/40 or better was achieved in 27 eyes (90.0%) in group Ⅰ, and 35 eyes (92.1%) in group Ⅱ and the difference was not statistically significant (P>0.05). In group Ⅰ, 23 eyes (76.7%) had a total of 40 complications, while 13 eyes (34.2%) had 19 complications in group Ⅱ (P<0.05). Gonioscopy and ultrasound biomicroscopy showed that in group Ⅰ, all haptics of IOLs contacted with the iris completely and compressed the iris to different degrees, sometimes causing the anterior chamber angles to widen. Anterior synechia of the iris was caused by the haptics of FOAC-IOLs in 12 eyes. Among the 60 IOLs haptics, 39 foot plates of the haptics were properly fixed at the ciliary band; 21 haptics (12 eyes) penetrated through the iris into the stroma of the ciliary body with accompanying recurrent uveitis. In group Ⅱ, among the 76 IOLs haptics, 52 were adequately fixed in the ciliary sulcus regions, and 8 (8 eyes) were placed below the iris, causing goniosynechia. This type of angle closure was localized, with an open angle on each side of the haptics. The remaining 16 haptics were fixed onto the ciliary crown.Conclusions The current sutured mode of scleral fixated PC-IOLs can not ensure that IOLs haptics are placed in the ciliary sulcus. The haptics of FOAC-IOLs compress the iris and may penetrate through the iris into the stroma of the ciliary body. This can cause peripheral iris anterior synechia and chronic recurrent uveitis. The implantation of scleral fixated PC-IOLs is safer and shows better effects than that of FOAC-IOLs.