Obesity has been widely accepted as a metabolic disease and its occurrence is closely related to the genetics, environment, and inflammation. Up to now, body mass index is still regarded as the standard diagnostic criterion for obesity. It has not been revised for decades and could not meet the needs of clinical diagnosis and demands for specific treatment at present. In 2013, the concept of metabolic obesity was introduced at the American Diabetes Association ( ADA) annual conference, and it was further proposed that obesity should be classified according to the metabolic status and its related complications at the 2014 American Association of Clinical Endocrinologists ( AACE) annual conference. This means that scientists and clinicians have realized that the etiology of obesity may vary with different outcomes, the treatment should be focused on the metabolic regulation, not merely on weight loss. With years of clinical practice and research in obesity, we have observed and treated numerous obese patients, and we have found that obesity has a lot of phenotypes and clinical features which are related to the metabolic status. Based on our clinical findings, combined with the experience of Chinese traditional medicine, we now propose a new clinical classification and diagnosis of obesity based on individuals′ metabolic status, which, we believe, can facilitate clinicians′practice. Based on the metabolic status and skin features of obese patients, obesity is divided into metabolic healthy obesity (‘white obesity’) and metabolic unhealthy obesity. Then, the latter is further divided into three groups including high metabolic obesity (‘red obesity’ ) , low metabolic obesity (‘yellow obesity’ ) , and severe metabolic disorder with inflammation obesity (‘black obesity’ ) . If we also consider to add normal weight metabolic obesity to this classification, there should be five types of obesity to be classified as presented. We wish this proposed classification of obesity can play a valuable role in enabling clinicians to have a better understanding of obesity in relation to its metabolism, and to develop individualized treatment according to the metabolic status of the patient. As a result, we may finally achieve the desired outcomes through making appropriate diagnosis and treatments.

Objective To study the biological function of Topical Oxygen Therapy(TOT) and Infrared Light-Emitting Diode(LED) therapy and mechanism of combination of both therapy in wound healing.To develop a device combined with TOT and LED therapy.Methods Wound models were made using rabbits which were grouped in four groups such as control group,TOT group,LED group and combined group by random.Except control group,the other groups were carried on TOT,LED and TOT+LED therapy respectively.Wound healing situations were observed.Results TOT+LED therapy could cut the wound healing time whose mechanism was to form composition force in the processing of wound healing by prompting inside growth factors and outside factors.Conclusion The therapy combined with TOT and LED can facilitate the wound healing.The theory of the wound healing device is feasible according to the results of the experiments.

Objective To evaluate the cooperation and nursing during esophageal variceal ligature with painless endoscopy.Methods The cooperation and nursing intervention of 290 patients with esophageal varices treated with painless endoscopic loop ligature from January to December 2009 were analyzed retrospectively.Results The treatment of 290 patients were succeessful.There was no anesthetic accident and serious complication.The treatment was successfully completed in the safe,calm and comfortable painless condition.Conclusions Esophageal variceal ligature with painless endoscopy is a safe and painless method which is easily accepted by patiens.The key point of the successful treatment is close cooperation and the deliberate nursing.

Objective To observe the effet of gross saponin of tribulus terrestris(GSTT) on hemodynamics and oxygen metabolism in anesthetic thoraco-opened dogs.Methods Thirty dogs were randomly divided into negative control,positive control,and experimental groups(GSTT of 6.26,12.52,and 25.00 mg?kg~(-1))(n=6).The administration of intravenous injection was used.The effects of GSTT on the indexes of the hemodynamics and oxygen metabolism in anesthetic thoraco-opened dogs were observed.Results Compared with controls GSTT increased myocardial blood flow(CBF)(P

Platelet-rich plasma is a volume of autogenous plasma with a high platelet concentration. Platelet-rich gel which is polymerized from platelet-rich plasma becomes a hot topic in the repairing of jaw bones in oral and dentofacial surgery. Presently, the mechanism of platelet-rich gel in enhancement of bone defect repair has not been clarified. Generally, we believed that the unifiation of blood platelet degranulation released many high-concentration growth factor during polymerization stimulated bone formation and accelerated bone repair. In addition, the application of platelet-rich gel has some problems. Thus, wide application of platelet-rich gel in tissue engineering deserves further studies. With the development, platelet-rich gel should be widely used in bone tissue engineering.

Objective To explore the effects of lithium on expressions of cyclin-dependent kinase 5 (CDK5) and protein phosphatase 2A (PP2A) in the brains of chronic aluminum exposure rats so as to further understand the mechanism of lithium's inhibition on tau phosphorylation. Methods We divided 12 chronic aluminum chloride exposure rats into treatment group and non-treatment group (6 rats in each). Treatment group was given lithium chloride (200 mg/kg?d) via gastric perfusion daily for 6 weeks,while the non-treatment group sodium chloride at the same dosage and the normal group (6 non-aluminum exposure rats of the same month old) without intervention. Six weeks later,all the rats received Morris water maze test for learning memory function; CDK5 and PP2A expressions and phosphorylated tau protein level in rat hippocampus were determined by Western blotting. Results Compared with normal group,non-treatment of chronic aluminum exposure group showed higher phosphorylated tau protein level and CDK5 expression in the brain (P0.05). Conclusion Lithium may reduce tau phosphorylation and neurofibrillary tangle formation by inhibiting the expression of CDK5.

Objective To study the neurodevelopmental outcome prospectively at 18 months of the late preterm infants.Methods Data from 7 584 live born neonates were collected between January and December.2009 in 3 hospitals located in the north of Chengdu City,Sichuan Province were collected,89 late preterm infants were brought into study ; 170 healthy full-term infants were chosen as the controls randomly.Neurodevelopment outcome was assessed by using neonatal behavioral neurological assessment(NBNA) at 40 weeks corrected gestational age,and Bayley scales of infant development was performed to obtain the physical development index (PDI) and mental development index (MDI) at 3,6,9,12 and 18 months corrected age.Neurodevelopmental outcome of late preterm infants was studied compared with that of the term infants.Results Sixty-three neonates born at the late preterm phase and 115 neonates born at the term phase were successfully followed up.The NBNA scores of the late preterm infants at 40 weeks corrected gestationa] age were significantly lower than those of the term infants.The proportion of the late preterm infants whose scores ≥37 was significantly lower than that of the term infants(82.5％ vs 94.8％),the proportion of late preterm infants whose scores ＜35 was significantly higher than that of the term infants(4.8％ vs 0),the proportion of the late preterm infants whose scores in 35-36 was significantly higher than that of the term infants (12.7％ vs 5.2％,Z =-2.707,P ＜ 0.05) ;At 3,6,9 and 12 months corrected age,the late preterm infants showed a significant lower PDI scores(t =-4.266,-4.594,-5.663,-2.584) and MDI scores (t =-7.121,-7.829,-7.038,-6.002) than those of the term infants(all P ＜0.05).Compared with the term infants,the late preterm infants still had lower MDI scores than the term infants at 18 months corrected age(t =-4.115,P ＜0.05),but no difference was observed in PDI scores between late preterm and the term infants (t =-0.957,P ＞ 0.05).Conclusions Neurodevelopment outcome of the late preterm infants is delayed in the first year compared with term infants.At 18 months corrected age the mental development is still delayed compared with the term infants.Measures should be taken properly to improve the neurodevelopment of the late preterm infants in the early childhood.

Objective To study the effects of mifepristone on the expression of estrogen receptor(ER)? and progesterone receptor(PR) in the endometrium of patients with adenomyosis in different menstrual cycles. Methods Forty-seven patients with adenomyosis and 15 normal subjects were divided into 3 groups: mifepristone group(n=24),non-drug group(n=23) and control group(n=15).The expression of ER? and PR in eutopic,ectopic and normal endometrium in proliferative phase and secretory phase were detected by immunohistochemistry. Results In non-drug group,the expression of ER? and PR in ectopic endometrial glandular and stromal cells was significantly lower than that in eutopic and normal endometrium(P0.05).The expression of ER? and PR in both ectopic and eutopic endometrial glandular and stromal cells in mifepristone group was lower than that in the non-drug group(P

Objective To explore the expression of annexin A10 (ANXA10) in human hepatocellular carcinoma (HCC),and analyze its correlation with matrix metalloproteinases-9 (MMP-9) and vascular endothelial growth factor (VEGF),thus to provide the basis for clinical diagnosis and assessment of HCC.Methods 88 HCC patients were selected,and they were all performed surgical treatment,HCC stage Ⅰ in 11 cases,stage Ⅱ 25 cases,stage Ⅲ 31 cases,stage ⅣV 21 cases.The expressions of ANXA10,MMP-9,VEGF of HCC cancer tissues,adjacent liver tissues and normal liver tissues were tested by immunohistochemical method.The correlation of ANXA10 with VEGF and MMP-9 was analyzed.Results The absorbance value of ANXA10 expression in the HCC cancer tissue was (0.074 ± 0.012),which was lower than that in the adjacent liver tissues [(0.091 ± 0.013)] and normal liver tissues[(0.131 ±0.025)],and ANXA10 expression of the adjacent liver tissue was lower than that of the normal liver tissues,the differences were statistically significant (t =8.96,9.44,8.71,all P ＜ 0.05).The absorbance values of MMP-9 and VEGF expression in the HCC cancer tissue were (0.147 ± 0.017) and (0.127 ± 0.028),respectively,which were higher than those in the adjacent liver tissues [(0.096 ± 0.012),(0.091 ± 0.015)] and normal liver tissues [(0.075 ± 0.014),(0.077 ± 0.019)].The absorbance values of MMP-9 and VEGF of the adjacent liver tissues were higher than those of the normal liver tissues,the differences were statistically significant (t =8.05,9.30,8.11;8.28,9.51,8.02,all P ＜ 0.05).The absorbance value of ANXA 10 expression in the HCC stage Ⅲ + Ⅳ cancer tissue was (0.056 ± 0.010),which was lower than that in the stage Ⅰ + Ⅱ cancer tissue [(0.082 ±0.016)],the difference was statistically significant (t =8.90,P ＜ 0.05).The absorbance values of MMP-9 and VEGF expression in the stage Ⅲ + Ⅳ cancer tissue were (0.157 ± 0.022) and (0.169 ± 0.033),respectively,which were higher than those in the stage Ⅰ + Ⅱ cancer tissue [(0.114 ±0.015),(0.091 ±0.021)],the differences were statistically significant (t =9.13,9.72,all P ＜ 0.05).ANXA10 was correlated with MMP-9 and VEGF (r =0.324,0.295,all P ＜ 0.05).Conclusion ANXA10 presents lower expression in HCC cell,and the expression decreased with the increase of staging.It is negatively related with the MMP-9 and VEGF.ANXA10 expression missing or inactivation of malignant change may be one of the most important features in HCC.

Objective To evaluate the curative effects and safty of contra-aperture dissection and skin bridge preservation in the treatment of low transphincteric perianal fistula.Methods Sixty subjects of low transphincteric perianal fistula were randomly divided into two groups.Thirty cases of treatment group were treated by contra-aperture dissection and skin bridge preservation,and 30 cases of control group were treated by anal fistulectomy.On the second,seventh and fourteenth day after operation,the postoperative pain,exudate and fever were recorded and scored.The curative time was observed.Anorectal dynamic changes were compared simultaneously to evaluate the curative effects and safety of contra-aperture dissection and skin bridge preservation.Results The scores of pain and exudate were significantly different between the treatment and the control group(P＜0.01).The wound-healing time was shorter in the treatment group than that in the control group((27.37±8.93) d vs.(32.73±9.45) d,P=0.000).There were significant differences in the anal resting pressure,anal maximal contraction pressure and active systolic pressure between the two groups (t =13.12,10.21,12.10;P＜0.01).There was no significant difference of total effect between the two groups(100％ and 93.3％;x2 =2.07,P＞0.05).Conclusion Contra-aperture dissection and skin bridge preservation can reduce postoperative pain,exudate and fever,shorten wound-healing time and protect anal functions in the treatment of low transphincteric perianal fistula.