Objective:To examine the effects of Zishenwan Prescription on bile acid metabolism in mice with diabetic encephalopathy; To explore its mechanism of improvement of diabetic encephalopathy.Methods:Male C57BL/6J mice were used to replicate the mouse model of type 2 diabetes mellitus by using high-fat chow and a single intraperitoneal injection of streptozotocin (120 mg/kg). The mice were screened for diabetic encephalopathy by using the Morris water maze test after 8 weeks of continuous stimulation with hyperglycemia, and were divided into model group and Zishenwan Prescription group according to random number table method, with 12 mice in each group. The mice in the Zishenwan Prescription group were treated with the crude extract of Zishenwan Prescription (9.36 g/kg) by gavage, and the normal group and the model group were treated with the same volume of distilled water once a day for 8 weeks. At the end of the treatment, Morris water maze test was used to investigate the cognitive function of diabetic encephalopathy mice; cresyl violet staining was used to detect the number of granule neurons in the hippocampus; serum and feces were collected to detect the content of bile acids by liquid-liquid coupling; hepatic bile acid synthase CYP7a1 and CYP27a1, farnesol X receptor (FXR), fibroblast growth factor 15 (FGF15), fibroblast growth factor receptor 4 (FGFR4), and ileocecal apical sodium-dependent bile acid transporter protein (ABST) mRNA levels were detected by using fluorescence quantitative PCR assay.Results:Compared with the model group, mice in the Zishenwan Prescription group had shorter evasion latency time ( P<0.05 or P<0.01), decreased time to first reach the platform ( P<0.01), increased number of times to traverse the platform ( P<0.01), and reduced neuronal cell damage in hippocampal area; mice in the Zishenwan Prescription group showed decreased serum and fecal total bile acid content ( P<0.05 or P<0.01); the liver CYP7a1 and CYP27a1 mRNA expressions increased ( P<0.01), and FXR and FGF15 mRNA expressions decreased ( P<0.01); ileal ABST mRNA expression decreased ( P<0.01). Conclusion:Zishenwan Prescription may regulate bile acid metabolism, inhibit FRX-FGF15/FGFR4 signaling and ABST expression to promote new bile acid synthesis and conjugated bile acid reabsorption, and thus improve cognitive function in diabetic encephalopathy mice.

Objective:To analyze the clinical practice of fertility preservation in unmarried young female breast cancer patients in China.Methods:This was a retrospective study of 13 unmarried female patients who underwent fertility preservation due to breast cancer in the Reproductive Medicine Center of International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine from January 2019 to December 2020.Results:The age of the patients was (31.00±3.98) years old. Nine patients used follicular phase letrozole (LE)+gonadotropin (Gn) ovarian stimulation protocol, 3 patients used luteal phase LE+Gn stimulation protocol, and 1 patient used natural cycle protocol. Eleven patients completed the fertility preservation procedure, with a total Gn used dosage of (1 865.91±501.03) U, estradiol level at trigger of (1 223.85±709.75) ng/L, and 9.91±4.41 frozen oocytes. All of them used vitrification freezing.Conclusion:Oocyte vitrification frozen after LE+Gn ovarian stimulation is the preferred solution in young unmarried breast cancer patients for fertility preservation. However, promoting the awareness of fertility preservation, improving communication between clinical departments, and increasing clinical practice still need to be promoted.

Objective:To analyze the clinical practice of fertility preservation in unmarried young female breast cancer patients in China.Methods:This was a retrospective study of 13 unmarried female patients who underwent fertility preservation due to breast cancer in the Reproductive Medicine Center of International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine from January 2019 to December 2020.Results:The age of the patients was (31.00±3.98) years old. Nine patients used follicular phase letrozole (LE)+gonadotropin (Gn) ovarian stimulation protocol, 3 patients used luteal phase LE+Gn stimulation protocol, and 1 patient used natural cycle protocol. Eleven patients completed the fertility preservation procedure, with a total Gn used dosage of (1 865.91±501.03) U, estradiol level at trigger of (1 223.85±709.75) ng/L, and 9.91±4.41 frozen oocytes. All of them used vitrification freezing.Conclusion:Oocyte vitrification frozen after LE+Gn ovarian stimulation is the preferred solution in young unmarried breast cancer patients for fertility preservation. However, promoting the awareness of fertility preservation, improving communication between clinical departments, and increasing clinical practice still need to be promoted.

Objective: To understand poor oral habits of preschool children and related factors, so as to provide evidence for child oral health promotion. Methods: A total of 3 094 preschool children from 12 kindergartens in Wuhan and Ezhou were selected by cluster sampling method. Basic demographic information and child poor oral habits were evaluated through questionnaire survey. Chi square test was used for univariate analysis and binary Logistic regression was performed for multivariate analysis. Results: About 33.5% of preschoolers were found to have poor oral habits. Among them, biting nails and toys (4.4%), sucking fingers ( 3.8% ), mouth breathing (3.7%) ranked the highest. Multivariate analysis showed that only child( OR =1.26), picky eaters( OR =1.30), and exposure to second hand smoke ( OR =1.69) were associated with poor oral habits, while living in cities( OR =0.58), high family economic status ( OR =0.66), and good health ( OR =0.37), balanced diet ( OR =0.71), maternal high school education ( OR =0.72) were associated with better oral habits( P <0.05). Conclusion Preschool children s oral habits are affected by variable factors, attention should be paid to children who are the only child of the family, picky eaters, living in rural areas, and those exposed to second hand smoke.

Objective: To analyze the prevalence and changing trend of overweight and obesity among high school seniors in Beijing from 2009 to 2018, and to provide scientific basis for health and education departments to work out effective measures to prevent and control overweight and obesity among adolescents. Methods: The physical examination data of 700 588 high school seniors in Beijing from 2009 to 2018 were selected to describe the distribution characteristics of the detection rate of overweight and obesity, and to analyze whether there are differences in the prevalence of overweight and obesity among different genders and regions. Results: From 2009 to 2018, the prevalence rate of total overweight and obesity of high school seniors in Beijing showed an increasing trend by year ( χ 2=3.58, P <0.01). After 2016, the rising trend was more stable, and it declined for the first time in 2018. The prevalence of overweight ( χ 2=6 681.34, P <0.01) and obesity ( χ 2=15 663.08, P <0.01) were higher in male than in female. The prevalence of overweight and obesity in urban students was higher than that in suburban students (29.55%,27.95%; χ 2=211.43, P < 0.01 ), the prevalence of obesity in urban students was higher than that in suburban students from 2009 to 2013, and the prevalence of obesity in suburban students was higher than that in urban students from 2014 to 2018. The districts and counties with the highest detection rates of overweight and obesity are Shijingshan District (overweight: 19.06%, obesity: 13.99%), and the districts and counties with the lowest detection rates of overweight and obesity are Yanqing District (overweight: 13.48%, obesity: 7.18%). Conclusion From 2009 to 2018, the prevalence of overweight and obesity among high school seniors in Beijing has been increasing by year, and tends to be stable after 2016. Significant upward trend in obesity prevalence in suburban areas of Beijing has been observed.

OBJECTIVE：To investigate the clini cal features of thrombocytopenia induced by antidepressants ，and to provide reference for the rational use of clinical drugs. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，PubMed and Web of Science，during Jan. 1st in 1985 to Aug. 31st in 2020，case reports about antidepressants-induced thrombocytopenia was collected and analyzed descriptively in terms of demographic characteristics ，medication，clinical manifestations ，treatment and outcome. RESULTS：A total of 17 literatures were retrieved ，and 19 patients were included ，involving 10 male and 9 female，aged from 5 to 95 years old ，with an average of （48±24）years old. Nine kinds of drugs were involved ，including 4 cases of escitalopram ，3 cases of citalopram ，3 cases of fluoxetine ，3 cases of mirtazapine ，2 cases of amitriptyline ，1 case of sertraline ，1 case of paroxetine，1 case of mianserin and 1 case of imipramine. There were 9 cases of single drug and 10 cases of drug combination. All 19 patients suffered from thrombocytopenia at 3 d-10 years after medication ，14 of them had hemorrhage tendency. Main clinical manifestations included mucocutaneous hemorrhage ，gingival bleeding ，black stool ，hematochezia，vaginal bleeding ，ocular hemorrhage，alveolar hemorrhage. No bleeding was found in 5 cases. After drug withdrawal/changing drugs and other symptomatic treatment， platelet count of 19 patients recovered to normal ， and bleeding symptoms disappeared. CONCLUSIONS ： Thrombocytopenia caused by antidepressants has no obvious clinical features and is not easy to be found ，but it may lead to severe； bleeding symptoms if it is not found in time. The changes of platelet count should be closely monitored in clinical application of such drugs to ensure the safety of drug use.

Objective:To develop the UPLC-MS/MS method for the determination of amygdalin, cinnamic acid, rhein, emodin and glycyrrhizic acid in Taohe-Chengqi Decoction simutaneously. Methods:The separation was performed on Supelco Discovery C18, and isocratic elution was carried out with mobile phase consisting of acetonitrile - 4 mmol/L ammonium formate. The mass spectrometer was operated in the positive and negative ionization electrospray (ESI) mode using multiple monitoring (MRM) to analize of five ingredients. The precursor to product ion transitions monitored for amygdalin, cinnamic acid, rhein, emodin and glycyrrhizic acid were m/z 458.2→296.0, 146.8→103.1, 283.7→239.9, 269.7→226.1 and 821.4→350.9, respectively. Results:Amygdalin, cinnamic acid, rhein, emodin and glycyrrhizic acid were analyzed, the linear ranges were 0.001 6-0.102 4, 0.001 6-0.102 4, 0.001 6-0.102 4, 0.000 8-0.051 2 and 0.000 4-0.256 0 ng, respectively. The r were 0.998 7, 0.999 1, 0.999 5, 0.998 9 and 0.998 6, respectively. The recovery of five analytes ranges from 97.33% to 105.33% and the Relative Standard Deviations were all below 2.69%. Conclusion:This UPLC-MS/MS method is exclusive, rapid and sensitivewhich could be applied for the determination of amygdalin, cinnamic acid, rhein, emodin and glycyrrhizic acid in Taohe-Chengqi Decoction.

Metabolomics is an interdisciplinary subject that rose in the post-genomic era, which focuses on quantitative study of the response of living organisms to outside stimulation and pathophysiological changes, as well as multiple dynamic response of the level of in vivo metabolites caused by genetic mutation. It is extensively used in basic research of system biology, materia medica, clinical medicine, etc. In the forensic field, metabolomics mainly focuses on forensic toxicology, but with the generalization of certain techniques, it's foreseeable that metabolomics has a broad research prospect in forensic pathology. This article summarizes the major analysis techniques and methods of metabolomics, describes the research status of metabolomic techniques in the field of forensic pathology application research, including postmortem interval and death cause. Moreover, this article summarizes and discusses the potential applicable areas, in order to provide reference for relative research and application.
Autopsy ; Forensic Pathology/trends* ; Forensic Toxicology ; Humans ; Metabolomics ; Postmortem Changes

At present, diabetes mellitus has become an increasingly serious disease which affects public health in the word. Clinical treatment of diabetes is mainly based on oral hypoglycemic drugs, insulin injections and lifestyle interventions (diet and exercise) . The new intervention method targeting intestinal microflora opens up new ideas for diabetes treatment. This article reviews the application of new intestinal microbial therapy (probiotic treatment, oral prebiotics/synbiotics, fecal microbiota transplantation) and treatment by regulating intestinal microflora (bariatric surgery, antibiotic therapy and traditional Chinese medicine) in diabetes. This article also summarized the nursing intervention based on intestinal microbial therapy so as to improve the understanding of the relationship between intestinal microflora and diabetes, and provide a reference for treatment and nursing care for type 2 diabetes.

Objective To evaluate the changes in the expression of artemin in skin around the inci-sion during remifentanil-induced hyperalgesia in the rats with incisional pain. Methods Thirty-two healthy male Sprague-Dawley rats, aged 10-12 weeks, weighing 250-280 g, were divided into 4 groups (n = 8 each) using a random number table: control group (group C), incisional pain group (group I), remifen-tanil group (group R) and incisional pain plus remifentanil group (group I+R). Remifentanil was intrave-nously infused for 60 min at a rate of 1 μg·kg-1 ·min-1 in group R. In group I, the model of incisional pain was established, and the equal volume of normal saline was infused for 60 min via the tail vein at the same time. In group I+R, the model of incisional pain was established, and remifentanil was infused for 60 min via the tail vein at a rate of 1 μg·kg-1 ·min-1 at the same time. The equal volume of normal saline was infused for 60 min via the tail vein in group C. Mechanical paw withdrawal threshold (MWT) and ther-mal paw withdrawal latency (TWL) were measured at 24 h before infusion of remifentanil or normal saline and 2, 6, 24 and 48 h after the end of infusion (T0-4 ). Rats were sacrificed following the last measurement of pain threshold, and ipsilateral plantar skin was removed for detection of the expression of artemin protein and mRNA (by fluorescent quantitative real-time polymerase chain reaction or Western blot). Results Compared with group C, MWT was significantly decreased and TWL was shorten at T1-4 , and the expression of artemin protein and mRNA in plantar skin was up-regulated in R, I and I+R groups (P<0. 01). Compared with R and I groups, MWT was significantly decreased and TWL was shorten at T1-4 , and the ex-pression of artemin protein and mRNA in plantar skin was up-regulated in group I+R (P<0. 01). Conclu-sion The peripheral mechanism by which remifentanil induces hyperalgesia may be related to up-regulated expression of artemin in skin around the incision in the rats with incisional pain.