Obesity has become a social problem.Study shows that fat is closely related with chronic diseases.and the effect of body fat on body metabolism varies with its distribution.The discovery of fat as an endocrine organ provides a broad research areas for the relationship between body fat and chronic diseases.The difierense in fat distribution between different sexes suggests that gonadal hormone has obvious effects on body fat metabolism.As a result,hormone replacement therapy has become the optimal method for releasing climacteric symptom.With the development of people's living standards,the attention paid to the menopausal problem,the research on body fat changes and its relationship with chronic diseases,and the study on the effect of hormone replacement therapy on the body fat are of great importance.

AIM: To identify and quantitative analysis gentiopicroside content in the extract of Violent gentian of Tibetan herbal medicine. METHODS: Application of HPLC-the electricity sprays fog-mass spectroscopy/mass spectroscopy(HPLC-ESI-MS/MS) and the technique of LC-DAD-UV,by contrast with the reservation time of the authentic gentiopicroside,the ultraviolet absorbed spectrum,the molecule~+,quickly identified the gentiopicroside in the extract of violent gentian.As to it's quantitative analyis we adopted the capillary HPLC methods,with the weight of authentic gentiopicroside for abscissa. RESULTS: MS showed that the methanol extract of violet gentian mainly had five peaks.the compound structure of first peak was gentiopicroside,molecule~+ 356.9,result showed that gentiopicroside in gentian was 1.97%. CONCLUSION: Gentiopicroside is the mainly component of violet Gentia.

Virtual experiments teaching has been characterized by openness, interactivity and re-source sharing. It efficiently improves the experiments teaching effects and promotes the teaching reform. At present the virtual experiment systems used by domestic universities can realize simulation of the ex-perimental principle, apparatus, object, operation and data. In the virtual experiment system students deepen the understanding of the experiments through foregrounding and the networked virtual experiment manage-ment effectively improves the effects of experiments teaching through behind-the-scenes action.

Objective To investigate the expression of chemokine receptor CCR7 and its correlation with lymph node metastasis and prognosis in esophageal cancer after esophagectomy. Methods One hundred and eighty-four patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between June, 2003 and June, 2005. The expression of CCR7 was detected by immunohistochemistry. All statistic analyses were performed with SPSS 13.0 statistical software. According to the clinico-patho-logic factors, the difference of CCR7 expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The expression rate of CCR7 in stage Ⅰ , stage Ⅱ and stage Ⅲ patients was 25.0 % , 70.3% and 85.5% , respectively. The difference of CCR7 expression between stage Ⅱ and stageⅢ was statistically significant (x2 =5.0, P =0.02). The CCR7 expression rate in T1, T2 and T3 patients was 33.3% , 64.9% and 80.9% , respectively. The difference of CCR7 expression between T2and T3 was statistically significant (x2 =5.4, P =0.01). The level of expression of CCR7 in patients with lymph node metastasis was significantly higher than those without metastasis (x2 =10.8, P = 0.00). The 5-year survival rate instage Ⅰ , stage Ⅱand stage Ⅲ patients was 100.0% , 38. 3% and 22.4% , respectively. The 5-year survival rate in patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression (x2 = 23.7, P = 0.00). The 5-year survival rate in T2, T3, NO and N1 patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression The result of Cox analysis demonstrated that T , N and CCR7 overexpression were independent prognostic factors. Conclusion CCR7 expression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage,N stage and lymph node metastasis. The patients with CCR7 expression was significantly lower the 5-year survival rate than without CCR7 expression. T stage, lymph node metastasis and CCR7 expression were independent prognostic factors.

Objective: To explore the effect of radiotherapy on preventing the recurrence of lymph node metastasis of esophageal cancer after Ivor-Lewis esophagectomy. Methods: Three hundred and sixty-six pa-tients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients un-derwent Ivor-Lewis esophagectomy with two-field lymph node dissection in our hospital between June 1999 and June 2004. All statistical analyses were performed with SPSS 13.0 statistical software. Kaplan-Meier method was performed to calculate the relapse rate. Log-rank test was performed to compare the relapse rate. Cox regression analysis was performed to identify independent prognostic factors for postoperative lymph node metastasis. Results: Of the 366 cases, lymph node metastasis was found in 105 patients (28.5%)within 3 years after surgery, occupying 52.2% (105/201) of total recurrence. Of the 181 patients treated with postoperative radiotherapy, lymph node metastasis was found in 37 patients. The rate of lymph node metasta-sis was 20.4%, significantly lower than that in patients treated with chemotherapy alone and those without sys-temic adjuvant therapy (P<0.05). Chemotherapy was administered in 103 cases and lymph node metastasis was found in 33 patients. The rate of lymph node metastasis was 32.0%, lower than that in patients without systemic adjuvant therapy, but without statistical significance (P=0.17). The results of Cox analysis demon-strated that T stage, lymph node metastasis and postoperative adjuvant radiotherapy were independent prog-nostic factors. Conclusion: Ivor-Lewis esophagectomy for the middle third thoracic esophageal cancer was a safe surgical procedure. Postoperative radiotherapy is helpful for the control of local recurrence. T stage,lymph node metastasis and postoperative adjuvant radiotherapy are independent prognostic factors. Radio-therapy is helpful for preventing the recurrence of lymph node metastasis of esophageal cancer after Ivor-Lew-is esophagectomy.

Objective To investigate the expression of MTA1 protein and its relationship to the prognosis in esophageal cancer after esophagectomy. Methods One hundred and sixty-five patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between January 2002 and January 2004. The expression of MTA1 protein was detected by immunohistochemistry. All statistic analyses were performed with SPSS 10.0 statistical software. According to the clinicopathologic factors, the difference of MTA1 protein expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The 5-year survival rate in Ⅰ stage,Ⅱ stage and Ⅲstage was separately 100.0% 、38.3% and 22.4%, and the MTA1 protein expression rate in Ⅰ stage, Ⅱ stage and Ⅲ stage was separately 25.0% 、30.9% and 57.9%, the difference of MTA1 protein expression between Ⅱ stage and Ⅲ stage was statistically significant ( x2 = 11.6, P = 0. 00). The MTA1 protein expression rate in T1 stage, T2 stage and T3 stage was separately 42.9% 、13.3% and 50%. MTA1 protein expression rate in T2 stage patients and T3 stage patients was separately 13.3% and 50%, the difference of MTA1 protein expression between them was statistically significant (x2 = 13.2, P =0.00). The positive expression of MTA1 protein in patients with lymph node metastasis was significantly higher than those without metastasis ( x2 = 8.2, P = 0.04). The 5-year survival rate in patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression (P =0.00 ), and the 5-year survival rate in T3 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression ( P =0.01 ), and the 5-year survival rate in N0 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression (P = 0.03 ), and the 5-year survival rate in N1 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression ( P =0.04). However, the 5-year survival rate in T2 stage patients with MTA1 protein positive expression was not significantly lower than those without MTA1 protein positive expression (P =0.20). The result of Cox analysis demonstrated that N stage and MTA1 protein positive expression were independent prognostic factors. Conclusion MTA1 protein overexpression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage and lymph node metastasis. The patients with MTA1 protein overexpression was significantly lower the 5-year survival rate than without MTA1 protein expression. Lymph node metastasis and MTA1 protein overexpression were independent prognostic factors.

Objective To explore the effect of melatonin(MT) on the behavior of rats treated with noise stress and the related bio-mechanism. Methods Fifty rats were randomly divided into a blank group,two experimental groups and two control groups. The blank group was untreated. The experimental and control groups were exposed to 120dB noise stress for 1 day or 3 days, 8 hours per day, and treated with 15 mg/kg melatonin by intraperitoneal injection,or the same volume of physiological saline 30 minutes before noise stress. After noise stress,the rats' behavior was measured by open field test, learning and memory ability of rats was investigated with the method of Morris water maze and then nitric oxide (NO), superoxide dismutase (SOD) and malondialdehyde (MDA) contents in cerebral cortex and hippocampus of the rats were measured by TBA and Griess method respectively. Results No matter noise stress time was 1 day or 3 days, the excitability and explorative behavior of the 2 experimental groups(total movement distance (TMD) (1322.50 ± 504.32) cm, (1819.55 ± 458.37) cm, faster movement time (FMT) (68.49 ± 23.90) s, (87.34 ± 16.01) s, distance to center (DTC) (63.56 ± 2. 75) cm, (60. 13 ±1.87)cm, inner toriod time(ITT) (7.87 ±2.06)s,(9.60 ±2.89)s) in the open field test decreased significantly compared with those of the control group (TMD (2042.03 ± 449. 19) cm, (2325.73 ± 384.90) cm,FMT (109.32 ±21.84)s,(124.65 ± 16.74)s, DTC (58.00± 1.53)cm,(55.05 ±5.13)cm, ITT (12.84 ±3.62) s, (14.92 ± 2.75) s, P ＜ 0. 05, P ＜ 0.01);the escape latency of the experimental groups (( 10. 69 ±3.37) s, (18.87 ± 4.74) s) in Morris water maze was significantly shorter than that of the control group (( 23.86± 7.66)s, (33.55 ± 7.20)s, P＜ 0.05, P＜0.01). The contents of NO or MDA in cerebral cortex and hippocampus of the experimental groups (NO in cerebral cortex (3.35 ± 0.40) μmol/gprot, (4.50 ± 0.41) μmol/gprot, NO in hippocampus (2.24 ±0.18) μmol/gprot,(3.15 ±0.21) μmol/gprot, MDA in cerebral cortex(1.34 ±0.44)nmol/mgprot, (2.39 ± 0. 18) nmol/mgprot, MDA in hippocampus (0. 13 ± 0. 07) nmol/mgprot, (0.53 ± 0. 10)nmol/mgprot) were lower than those of the control group (NO in cerebral cortex (3.35 ± 0. 40) μmol/mgprot,(5.03 ± 0.44)μmol/mgprot, NO in hippocampus (2.93 ± 0. 31) μmol/gprot, (3.38 ± 0.24) μmol/gprot, MDA in cerebral cortex (2.24 ± 0.26) nmol/mgprot, (4.21 ± 0.21) nmol/mgprot, MDA in hippocampus (0.47 ± 0.29)nmol/mgprot, (1.33 ± 0. 187) nmol/mgprot, P ＜ 0.05, P ＜ 0. 01) respectively and the contents of SOD in cerebral cortex and hippocampus of the experimental groups (in cerebral cortex (763.95 ± 214.36) U/mgprot, (491.33 ±35.85) U/mgprot, in hippocampus (817.02 ± 232.39) U/mgprot, (644.85 ± 28.02) U/mgprot) were higher than those of the control group(in cerebral cortex (556.50 ± 101.51) U/mgprot, (327.35 ± 30.54) U/mgprot, in hippocampus (279.74 ± 117.02) U/mgprot, (108.75 ± 15.52) U/mgprot, P ＜ 0.05, P＜ 0.01) respectively. Conclusion Melatonin is effective in improving the ability of learning and memory in the rats of noise stress,possibly by inhibiting the increase of NO and MDA and increasing the SOD activity in cerebral cortex and hippocampus of the rats.

Objective: To investigate the effect of progressive early rehabilitation training in patients with severe acute pancreatitis. Methods: A total of 67 patients with severe acute pancreatitis requiring mechanical ventilation who were treated in the intensive care department of Shanghai first people's hospital from May 2015 to May 2018 were selected. According to the order of admission, they were divided into the control group (n=32) and the intervention group (n=35). On the basis of this nursing, the intervention group was jointly evaluated by the ICU rehabilitation team and adopted the progressive early rehabilitation nursing mode according to the different degrees of patients' conditions. The intervention effects of the two groups were compared. Results: The success rate of one-time weaning, mechanical ventilation time and ICU hospitalization time in the intervention group were 97.14% (34/35), (4.62±1.98) d, (8.76±1.02) d, and 78.12% (25/30), (9.01±2.15) d, and (14.01±2.87) d, respectively, in the control group. The difference between the two groups was statistically significant (χ² = 3.986, t=-5.012, -8.260, P < 0.05 or 0.01). The incidence of delirium, Barthel index (BI) scale score and grip strength score were 2.86% (1/35), 47.54±4.32, (34.05±10.68) kg, in the intervention group, 12.50% (4/32), 41.68±3.18, and (26.79±8.97) kg, in the control group, respectively. The difference between the two groups was statistically significant (χ²=4.024, t=7.651, 3.194, P < 0.05 or 0.01). Conclusions Progressive early rehabilitation training and nursing has a great influence on the prognosis of patients with severe acute pancreatitis, which can effectively improve the prognosis of patients, accelerate the recovery of patients, shorten the length of hospital stay and the duration of use of ventilator, reduce the incidence of delirium, help patients to restore muscle strength, and improve the Barthel index score of patients, which is worthy of promotion and application.

Objective:To study the early-onset epilepsy of intracerebral hemorrhage and build a prediction model to evaluate its prediction efficiency.Methods:A cross-sectional investigation was conducted to construct a specialized optimized prediction model. The prediction model was converted into a visual optimized scoring scale, so as to quantify the probability of secondary epilepsy after intracerebral hemorrhage. Based on the current prediction model of acute cerebral infraction and post-stroke seizure (AIS-PSS), the evaluation efficacy of optimized score for secondary epilepsy after hemorrhagic stroke was explored.Results:① After sample size calculation and sufficient inclusion and exclusion, 159 patients with cerebral hemorrhage were continuously selected as the model group of this cross-sectional study. A total of 29 patients with early-onset epilepsy and 130 patients without secondary epilepsy were enrolled. The time span was from January 2021 to August 2021. In addition, 77 patients with acute cerebral hemorrhage from August 2021 to February 2022 were selected as the verification group, among which 12 patients had early-onset epilepsy and 65 patients had not any secondary epilepsy. ② There were significant differences in demographic characteristics such as diabetes history, cerebral infarction history, smoking history, National Institutes of Health Stroke Scale (NIHSS) score, intracerebral hemorrhage hematoma volume, serum creatinine (SCr), neuron-specific enolase (NSE), S-100 protein and intracerebral hemorrhage site between the two model groups with different prognosis (all P < 0.05). ③ The above indexes were included in univariate and multivariate Poisson regression analysis, and the results showed that the duration of diabetes [relative risk ( RR) = 1.229, 95% confidence interval (95% CI) was 1.065-1.896, P = 0.036], smoking history ( RR = 1.419, 95% CI was 1.133-2.160, P = 0.030), history of cerebral infarction ( RR = 1.634, 95% CI was 1.128-2.548, P = 0.041), hematoma volume of cerebral hemorrhage ( RR = 1.222, 95% CI was 1.024-2.052, P = 0.041), NES content ( RR = 1.146, 95% CI was 1.041-1.704, P = 0.032), were independent influencing factors to constitute the prediction model. The prediction model was converted into a visual optimized scoring scale in the form of a line diagram to obtain the prediction probability corresponding to the corresponding score. ④ Receiver operator characteristic curve (ROC curve) was used to test the evaluation efficiency of optimized score and AIS-PSS score for early-onset cerebral hemorrhage epilepsy. Relevant data of patients in the verification group were extracted according to the information of two scores, and the final score of each patient in the verification group was obtained. The score and prognosis were put into the ROC curve to evaluate the predictive ability of different prediction models. The results showed that the cut-off value of the optimized score and the AIS-PSS score were 144 points and 7 points, respectively, and the area under the ROC curve (AUC) and the Yoden index of the optimized score were slightly lower than the AIS-PSS score. However, compared with AIS-PSS score, there was no significant difference in the evaluation efficiency of optimized score for early-onset epilepsy ( Z = 1.874, P > 0.05). Conclusion:This study constructed a specific early-onset epilepsy prediction model for patients with hemorrhagic stroke, and transformed it into an optimized score that is easy for clinical use, and its evaluation efficiency is reliable.

Objective To evaluate the effect of electroacupuncture at Chize and Shangjuxu on the prognosis and respiratory dynamics in patients with acute respiratory distress syndrome(ARDS).Methods A prospective randomized controlled study was conducted to collect patients with ARDS admitted to the Department of Emergency Medicine of Tongde Hospital of Zhejiang Province from December 2020 to September 2022.A total of 142 patients with ARDS from the Department of Emergency Medicine of Tongde Hospital of Zhejiang Province were selected for this study.Seven patients were excluded due to rapid deterioration,3 patients withdrew the informed consent,and finally 132 patients were enrolled.According to the order of enrollment,they were randomly divided into the electroacupuncture group and the conventional treatment group based on the random number table.The conventional treatment group received conventional treatment for ARDS,while the electroacupuncture group combined with electroacupuncture at Chize and Shangjuxu,the treatment lasted for 30 minutes.The mortality at day 60 and secondary efficacy indicators such as hospital stay,ventilator-free days at 28 day,and mechanical ventilation time of two groups were compared,and the indicators of respiratory mechanics and oxygenation such as inhalation oxygen concentration(FiO2),tidal volume(VT),positive end-expiratory pressure(PEEP),plateau pressure(Pplat),lung static compliance(Cst),oxygenation index(PaO2/FiO2)were also compared.Then the Kaplan-Meier survival curves were drawn to compare the differences in cumulative survival rates within 60 days between the two groups.Results The mortality at day 60 in the electroacupuncture group was lower than that in the conventional treatment group[33.33％(22/66)vs.40.91％(27/66)],but the difference was not statistically significant(P>0.05),and the hospital stay in the electroacupuncture group was significantly shorter than that in the conventional treatment group(days:25.09±11.57 vs.30.21±15.94,P<0.05).The ventilator-free days at 28 days in the electroacupuncture group were significantly higher than those in the conventional treatment group(days:10.06±7.35 vs.7.67±5.72,P<0.05).There was no statistically significant difference in mechanical ventilation time between the two groups(days:15.70±9.05 vs.18.39±9.55,P>0.05).After 72 hours of treatment,the FiO2,VT,and PaCO2 levels in the electroacupuncture group were significantly lower than those in the conventional treatment group[FiO2:0.39±0.07 vs.0.44±0.09,VT(mL/kg):6.27±0.74 vs.6.62±0.74,PaCO2(mmHg,1 mmHg≈0.133 kPa):39.94±4.52 vs.41.95±4.19,all P<0.05].Conclusion Electroacupuncture at Chize and Shangjuxu can effectively shorten the course of ARDS and improve prognosis,which may be related to the improvement of respiratory dynamics by electroacupuncture treatment.