Objective To study the effects of diacylglycerol(DG)on body weight of rats and its possible metabolic mechanism. Method (1) SD rats (n=30) were randomly divided into 3 groups. They were given free access to diets containing 7% (wt) triacylglycerol (TG, control group), 20% (wt) TG or 20% (wt) DG diets, respectively for 8 w. The changes of body weight, height, food intake, and feces were recorded. At the end of experiment, abdominal fat weight (including perirenal fat and epididymal fat), blood lipids were detected. (2) 13 w male Wistar rats (n=50) were divided into 2 groups(administrated with 10% TG or DG emulsion, respectively)in postprandial blood fat profile experiment. Blood lipids of 5 rats were analyzed at desired interval. (3) 6 w male Wistar rats (n=30) were randomly divided into 3 group, control group, DG group and TG group, administrated with glucose solution, 20%DG emulsion and 20%TG emulsion respectively for 6 d. Urine in 144 hr was collected continuously and analyzed for total ketone bodies. Results High DG diet resulted in a significant reduction in both body weight gain, ratio of abdominal fat to body weight and serum TG levels compared with the high TG diet. DG group have higher FFA level in portal vein and lower TG level in jugular vein than those of high TG group. But urine ketone body level of high DG group was higher than high TG group. Conclusion Dietary DG reduced fat accumulation inabdominal region, body and blood, and these effects may be involved with different metabolic ways of DG compared with TG.

Objective To analyze the nutritional composition of lipids in silkworm chrysalis (Bombyx mori L.). Method Crude lipids were extracted by chloroform/methanol, and fatty acid, tocopherol, sterol and phospholipid composition in silkworm chrysalis were determined by GC, HPLC and TLC methods. Results Silkworm chrysalis was rich in lipid (32.79%) in which the most abundant fatty acids were C18:3 (32.79%), C18:1 (32.53%), C16:0 (22.42%), but C18:2 (4.37%), C18:0 (5.73%) and C16:1 (0.57%) were relatively less. The sterols included cholesterol (67.35%), ?-sitosterol (19.21%), and trace amount of campesterol (0.28%) and brassicasterol (0.30%). Total tocopherols detected were at an average concentration of 486 mg/kg, including ?-tocopherol (44.85%), ?(+ ? )-tocopherol (44.57%), and ?-tocopherol (10.85%). The phospholipid content was about 1.17mg/g, among which, phosphorylcholine about 41.8%. Conclusion Silkworm chrystalis (Bombyx mori L.) could be a good source of nutritional edible oil rich in unsaturated fatty acid, phospholipids, phytosterols and tocopherols, particularly ?-linolenic acid, ?-sistosterol and ?-tocopherol.

Objective To explore the effect of lean management on cost control of single disease in patients with acute cerebral infarction (ACI) in stroke center. Methods A retrospective study was conducted. The patients with ACI who underwent intravenous thrombolysis in the stroke center of Taizhou Central Hospital in Zhejiang Province were enrolled. Thirty patients adopted traditional management procedures from July 2016 to September 2017 were enrolled in the control group, and 32 patients received lean management from October 2017 to December 2018 were enrolled in the lean group. The patients in the control group were treated with traditional intravenous thrombolysis, and the patients were sent to the neurology ward for intravenous thrombolysis. The patients in the lean group applied lean management value stream to optimize process management, the lean management team of the stroke center was established, and the green channel for stroke treatment was established to eliminate the waiting time as far as possible. The location of thrombolysis was changed from neurology ward to the neurological intensive care unit (NICU) in emergency department. The patients in the two groups were compared in terms of intravenous thrombolytic door-to-needle time (DNT), admission time to the neurologist's visit time (T1), CT examination time to neurology ward or NICU admission time (T2), neurology ward/NICU visit time to medication time (T3), and the proportion of patients with DNT controlled within 40 minutes, recovery of neurological impairment 7 days after thrombolysis [national institutes of health stroke scale (NIHSS) score], activity of daily living assessment (Barthel index), length of hospital stay, cost of hospital stay and patient satisfaction. At the same time, the main process quality and the implementation rate of easily missed indexes of cerebral infarction single disease were recorded. Results Compared with the control group, DNT, T1 and T2 in the lean group were significantly shortened [DNT (minutes): 39.56±11.12 vs. 63.03±19.63, T1 (minutes): 16.23±6.79 vs. 33.48±12.63, T2 (minutes): 13.45±3.84 vs. 17.47±5.56, all P < 0.01], T3 was slightly shortened (minutes: 9.88±1.95 vs. 10.95±2.69, P > 0.05), and the proportion of DNT control within 40 minutes was significantly increased [75.0% (24/32) vs. 16.7% (5/30), P < 0.01], the 7-day NIHSS score was decreased significantly (8.66±4.12 vs. 13.00±5.63, P < 0.01), 7-day Barthel index was increased significantly (71.6±16.7 vs. 54.7±17.1, P < 0.01), the length of hospital stay was significantly shortened (days: 9.69±4.06 vs. 12.47±3.83, P < 0.01), the hospital costs were significantly reduced (Yuan: 16 338±5 481 vs. 19 470±5 495, P < 0.05), the satisfaction of patients was improved significantly [(91.38±2.69)% vs. (86.53±2.78)%, P < 0.01]. In terms of the implementation rate of quality indicators such as pre-application evaluation of thrombolytic drugs, evaluation of dysphagia, and evaluation of vascular function, health education of ACI, rehabilitation evaluation and implementation within 24 hours, etc., the lean group was significantly improved as compared with the control group [(87.5% (28/32) vs. 53.3% (16/30), 96.9% (31/32) vs. 73.3% (22/30), 78.1% (25/32) vs. 43.3% (13/30), 100.0% (32/32) vs. 76.7% (23/30), 75.0% (24/32) vs. 33.3% (10/30), all P < 0.05]. Conclusion Lean thinking can realize the standardization of stroke center process, effectively utilize medical resources, improve medical quality and reduce the cost of cerebral infarction single disease.

Objective:To investigate the application value of transcranial Doppler (TCD) in the prognosis assessment of nerve function in patients with acute cerebral infarction (ACI) after intracranial mechanical thrombectomy.Methods:A retrospective analysis was conducted. The clinical data of 43 patients with acute anterior circulation cerebral infarction who received intra-arterial mechanical thrombotomy for recanalization admitted to Taizhou Central Hospital from January 2018 to December 2019 were analyzed. The modified Rankin scale (mRS) score of patients were followed up by telephone at 3 months after surgery to evaluate the prognosis of neurologic outcome. Patients with mRS score 0-2 were enrolled in the good prognosis group, while those with a score of 3-6 were enrolled in the poor prognosis group. The gender, age, past history, underlying diseases, occluded arteries, atherosclerotic stenosis and bridging treatment, time from onset to reperfusion, blood flow dynamics under TCD at 1 day after thrombectomy, and National Institutes of Health stroke scale (NIHSS) scores before and 1, 7, and 14 days after thrombectomy were compared between the two groups. Multivariate Logistic regression analysis was used to screen the prognostic factors of nerve function at 3 months after mechanical thrombectomy in patients with ACI. The receiver operating characteristic (ROC) curve was drawn to evaluate the prognostic value for neurological function assessed by TCD.Results:Forty-three patients were enrolled in the final analysis, with 23 patients in the good prognosis group and 20 in the poor prognosis group. The recanalization was successfully achieved in both groups without complications. However, the hemodynamics of intracranial arteries evaluated by TCD 1 day after operation in both groups still showed partial or complete occlusion, and the hemodynamics of patients in the poor prognosis group was worse than that in the good prognosis group (poor blood flow: 40.0% vs. 0%, inadequate blood flow: 30.0% vs. 17.4%, good blood flow: 30.0% vs. 82.6%), and the differences were statistically significant (all P < 0.01). Before thrombotomy, there was no significant difference in NIHSS score between the two groups. After thrombotomy, the NIHSS score of the two groups gradually decreased with the extension of time, but the NIHSS score at 14 days after operation of the poor prognosis group was still significantly higher than that of the good prognosis group (10.55±2.93 vs. 4.65±1.70, P < 0.01). Univariate analysis showed that compared with the good prognosis group, the proportion of patients with diabetes and arteriosclerosis stenosis in the poor prognosis group were significantly increased (30.0% vs. 4.3%, 45.0% vs. 17.4%, both P < 0.05), and the time from onset to reperfusion was prolonged (minutes: 385.9±96.2 vs. 294.5±95.1, P < 0.01). Multivariable Logistic regression analysis showed that the therosclerosis stenosis [odds ratio ( OR) = 9.334, 95% confidence interval (95% CI) was 1.092-79.775, P = 0.041] and the reperfusion time ( OR = 1.016, 95% CI was 1.006-1.027, P = 0.002) were associated with prognosis of nerve function at 3 months after mechanical thrombectomy in patients with ACI. ROC curve analysis suggested that the evaluation of intracranial hemodynamics by TCD might be able to predict the prognosis of neurological function in patients with ACI after 3 months of intracranial mechanical thrombectomy, the area under ROC curve (AUC) was 0.768 (95% CI was 0.620-0.917), the sensitivity was 65.0%, the specificity was 87.0%, the positive predictive value was 82.6%, and the negative predictive value was 70.0%. Conclusion:The evaluation of intracranial hemodynamics assessed by TCD is helpful in early judging the prognosis of neurological function in patients with ACI after intracranial mechanical thrombectomy.