Objective To explore the advantages, the operative key points and the clinical value of preliminary separation of bladder in laparoscope-assisted vaginal hysterectomy. Methods 126 patients wiht benign uterus lesions in the research group underwent preliminary sepation of bladder before receiving modified hysterectomy through peritoneoscope, and 128 randomly selected patients with benign uterus lesions underwent routine hysterectomy through peritoneoscope served as control. Results Successful treatment was got in the patients of both groups. There were significant differences in operative time, intraoperative hemorrhage, postoperative pain intensity, subcutaneous emphysema and postoperative disease incidence between the two groups(P0 05). Conclusion Preliminary separation of bladder in laparoscopic-assisted vaginal hysterectomy could effectively simplify operative procedures, shorten operative time, reduce intraoperative hemorrhage and the postoperative disease incidence, and had many advantages such as reducing difficulty in operation, improving surgical efficacy, increasing curative rates, and shortening hospitalization time and expense.

Objective To investigate the effects of resuscitation with limited fluid on rabbits with uncon-trolled hemordaagic shock. Method Uncontrolled hemorrhagic shock was produced in 40 rabbits. When the mean arterial pressure dropped to 40 manI-Ig and maintained for 30 minutes, resuscitation was initiated with Ringer solu-tion infusion into rabbits in large volume for group N3 (125 mL/kg) ,moderate volume for group N2 (92 mL/kg) and small amount for group N1 (57 mL/kg), and a drop of fluid was not given to rabbits of group N4. Besides, rob-bits of group N5 were controls without shock. MAP, fatality, volume of blood loss, SOD and Her were observed for 120 minutes or until death. Data were analyzed using SNK-q test and rank test. Results MAP, SOD and Het were higher, and fatality and blood loss were lower in group N5 than those in groups N1, N2,and N3 (P<0.01 ). MAP,fatality,blood loss and Het of group N4 were worse than those of groups N1,N2 and N3 (P<0.01). The blood loss and fatality in group N3 were significantly higher than those in groups N1 and N2 (P<0.01 ). SOD of kidney in group N3 was significantly lower than that in group N1 and N2(P<0.01). As the volume of fluid in-creased during resuscitation, Het of all animals was gradually becoming lower. As MAPS in groups N2, N3 and N4 were gradually becoming lower and lower, death increased. Conclusions Limited fluid resuscitation (57～92mL/kg) should be recommended to the therapeutic strategy for uncontrolled hemorrhagic shock.

Objective To establish a high-throughput evaluation model for anaphylactic reactions; To screen and identify potential anaphylactogens from TCM monomeric compounds.MethodsCell model of stably expressed MrgX2 was established. Recombinate plasmid pmCherry-C1-MrgX2 was transfected to HEK293 to establish cell line for screening model. MrgX2 agonist and antagonist were used to identify the validation and stability of the cell line. A small library consisting of 180 compounds was profiled by using a cell-based calcium mobilization assay to find novel compounds targeting the MrgX2 receptor. EC50 test, IC50 test, specificity validation and cytotoxicity evaluation were carried out to detect the function of the positive agonist.ResultsThe EC50 of C48/80 to MrgX2 model was 2.7 μg/mL and the IC50 of 2-APB (evoked by 10 μg/mL C48/80) was 46.29 μmol/L. The first generation cell model of MrgX2 was similar to the 20th generation, and the Z factor of MrgX2 cell model was 0.78. In the primary screening for agonist, isoliensinine was identified as a novel agonist targeting receptor MrgX2 with an EC50 of 4.5 μmol/L and IC50 of39.47 μmol/L. Moreover, isoliensinine was validated to activate MrgX2 receptor specifically without cytotoxicity. Conclusion A high-throughput evaluation method for anaphylactic reactions can be established in vitro through calcium mobilization assay. A potential anaphylactogen isoliensinine is identified and validated.

A collection of 57 natural compounds derived from Chinese herbal medicines were evaluated for their an-ti-adipogenic effects. The lipid droplets in differentiated 3T3-L1 adipocytes treated with tested substrate were de-tected by an image-based assay. The results demonstrated that oleanolic acid (OA) inhibited lipid droplets accumula-tion in 3T3-L1 adipocytes in a dose-dependent manner with the IC50 value of 14.5 μmol·L-1. In addition, ToxInsight assay showed that OA was free of liver injury for HepG2 cells within 60 μmol·L-1. It was concluded that OA, which had an obvious anti-adipogenic effect, can be a candidate for hyperlipidemia therapy.

Objective To observe the clinical efficacy of acupuncture at the nine acupoints on nape in treating vertebrobasilar ischemia (VBI). Methods Totally 100 VBI patients were randomized into a treatment group and a control group, 50 in each group. The treatment group was intervened by acupuncture at Fengfu (GV 16), Fengchi (GB 20), Wangu (GB 12), Tianzhu (BL 10), and Jiaji (EX-B 2, C3);while the control group was by oral administration of Nimodipine tablets. The parameters in Transcranial Doppler (TCD) and Dizziness Assessment Rating Scale (ADRS) were observed before and after intervention, and the clinical efficacies were compared. Results The TCD parameters were significantly changed in the treatment group after intervention (P<0.05). The TCD parameters [Vs (RVA), Vd (BA, LVA), Vm (BA, RVA), PI (BA)] were significantly changed in the control group after intervention (P<0.05). After intervention, there were significant differences in comparing the TCD parameters [Vs (BA, LVA, RVA), Vd (BA, RVA), Vm (BA, LVA), PI (BA)] between the two groups (P<0.05). The DARS average scores were significantly changed in both groups after 7-day treatment (P<0.01). The DARS average scores after the whole intervention were significantly different from that after 7-day treatment in both groups (P<0.01). There were significant differences in comparing the DARS average scores between the two groups after 7-day intervention and after the whole intervention (P<0.01). The recovery-markedly effective rate and total effective rate were respectively 76.0%and 98.0%in the treatment group versus 44.0%and 96.0%in the control group, and there was a significant difference in comparing the recovery-markedly effective rate (P<0.05). Conclusions Acupuncture at the nine nape acupoints is an effective method in treating VBI.

ObjectiveTo investigate the epidemiological characteristics of respiratory disease mortality in Baoshan residents during the period of 2009‒2020. MethodsRespiratory disease deaths of Baoshan residents from 2009‒2020 were collected. ICD-10 codes were used to classify the causes of death， and R-4.2.1 was applied for statistical analysis. The average annual percent change （AAPC） of standardized mortality rates of different respiratory diseases were analyzed by using Joinpoint 4.9.0.0. ResultsThe average annual mortality rate of respiratory diseases in Baoshan from 2009 to 2020 was 58.86/10⁵， and the standardized mortality rate was 35.62/10⁵， which was the 3rd leading cause of mortality. The mortality rate of respiratory diseases was higher in men than in women （χ²=46.70， P<0.001）. COPD ranked first among respiratory diseases in Baoshan from 2009 to 2020， followed by pneumonia， asthma and pneumoconiosis in that order. The standardized mortality rate for COPD decreased from 38.66/10⁵ in 2009 to 19.88/10⁵ in 2020 （AAPC=-6.6%， 95%CI： -8.2% to -4.9%， P<0.001）. The standardized mortality rate of asthma decreased from 2.86/10⁵ in 2009 to 1.43/10⁵ in 2020 （AAPC=-5.8%， 95%CI： -8.8% to -2.8%， P<0.01）. The standardized mortality rate of pneumoconiosis decreased from 0.64/10⁵ in 2009 to 0.12/10⁵ in 2020 （AAPC=-7.4%， 95%CI： -13.0% to -1.5%， P<0.05）. The standardized mortality rate for pneumonia decreased from 2.63/10⁵ in 2009 to 0.70/10⁵ in 2020 （AAPC=-6.2%， 95%CI： -12.2% to 0.2%， P=0.056）， but not statistically significant. The annual average mortality rates of COPD， pneumonia and asthma were all highest in January. Crude mortality rates for COPD （χ²=2 669.01， P<0.001）， pneumonia （χ²=217.82， P<0.001）， asthma （χ²=100.09， P<0.001）， pneumoconiosis （χ²=26.46， P<0.001） and all categories of respiratory diseases （χ²=2 995.84， P<0.001） increased with age showed an increasing trend. The crude mortality rates for COPD （χ²=101.69， P<0.001）， pneumonia （χ²=7.39， P<0.01） and asthma （χ²=7.41， P<0.01） were higher in the central than in the northern part of Baoshan District， while the crude mortality rate for COPD （χ²=19.97， P<0.001） was higher in the central than in the southern part. ConclusionThe attention should be focused on COPD； increased detection in males and the elderly， especially in winter and spring； and a good balance between environmental and economic when planning the regional development.

ObjectiveTo investigate the mortality and years of life lost of pancreatic cancer in Baoshan District of Shanghai，from 2009 to 2021， and to provide scientific evidence for the prevention and control of pancreatic cancer in the future. MethodsThe death surveillance data of Baoshan District from 2009 to 2021 were collected from the Shanghai chronic disease surveillance information management system. Crude mortality， standardized mortality，potential years of life lost （PYLL）， potential years of life lost rate （PYLLR） ， average years of potential life lost （AYLL） ， annual percentage change （APC） were calculated to analyze the trend of mortality and life loss of pancreatic cancer. ResultsFrom 2009 to 2021， a total of 2117 deaths of pancreatic cancer were reported in Baoshan District， accounting for 7.05% of all cancer deaths. The average age of the death cases was （71.18±10.97）years. The youngest was 3 years old and the oldest was 96 years old. The death component ratio of pancreatic cancer increased with time （P<0.05）， and the average death age of women was higher than that of men （P<0.05）. The crude mortality of pancreatic cancer was 17.38/10⁵ in Baoshan District from 2009 to 2021， showing a rising tendency （P<0.05） with APC of 3.74%. The standardized mortality of pancreatic cancer was 7.84/10⁵. The crude mortality of pancreatic cancer was 19.71/10⁵ in men and 14.89/10⁵ in women， both showed a tendency towards a rise （P<0.05 ） with APC of 4.44% and 2. 89%， respectively. The crude mortality of pancreatic cancer showed a tendency towards a decline in residents at ages of 45 to 60 years （ P<0.05 ）， with APC of 4.74%. The PYLL and PYLLR of pancreatic cancer were 8 115 person-years and 0.67‰ in Baoshan District from 2009 to 2021， while the AYLL of pancreatic cancer was 3.83 years per person. The PYLL was higher in men than in women. ConclusionThe mortality rate of pancreatic cancer in Baoshan District shows an increasing trend. The healthy life of elderly and men is affected largely by pancreatic cancer. It is necessary to strengthen the health education on the prevention/control of pancreatic cancer and healthy life style， thereby improving the tertiary prevention system of pancreatic cancer.