ObjectiveTo explore the possible mechanism of Gengxin Decoction （更欣汤） in the treatment of perimenopausal insomnia from the perspective of the expression of oestrogen receptor and orexin A （OXA） in hypothalamic tuberomammillary nucleus （TMN）. MethodsFemale ICR mice with regular estrous cycle were selected to establish perimenopausal insomnia mice models by injecting 4-vinylcyclohexene diepoxide （VCD） combined with para-chlorophenylalanine （PCPA） suspension intraperitoneally. After successful modeling， 75 mice models were randomly divided into model group， zopiclone group and low-， middle-， and high-dose Gengxin Decoction， with 15 mice in each group， and 15 normal mice were set as blank group. On the next day after successful modelling， mice in the low-， middle-， and high-dose Gengxin Decoction were given Gengxin Decoction granules 1.15， 2.3 and 4.6 g·kg^-1·d^-1 by gavage at 9：00 AM every day， mice in the zopiclone group were given zopiclone suspension 1.13 mg·kg^-1·d^-1 by gavage at the same time point， and mice in the blank and model groups were given distilled water 1 ml·kg^-1·d^-1 by gavage at the same time point， for 14 days in all groups. During the experimental period， general conditions of the mice in each group， such as daytime activities， mental state， diet and coat colour， were observed； twenty-four hours after the final intervention， the sleep latency and sleep duration of mice were detected by sodium pentobarbital synergy test， and the levels of serum estradiol （E₂）、progesterone （P）、follicle stimulating hormone （FSH） and OXA protein in TMN of hypothalamus were detected by ELISA， and the protein optical density values of estrogen receptor α （ERα）， OXA and ERβ in TMN was detected by immunofluorescence staining. ResultsThe circadian rhythm of mice was regular in the blank group； the circadian rhythm of mice was disordered in the model group， and they remained active during the day and night； the mental state of mice in each group of Gengxin Decoction was improved compared with that before， which showed that the daytime activity was less than before， and the coat color was slightly yellow but shiny， and the mental state of mice was significantly improved in the middle-dose Gengxin Decoction； the zopiclone group was less active during the day than before， had rough， less shiny hair， and was more alert. Compared with the blank group， the sleep latency of mice in the model group prolonged， the sleep duration shortened， serum E₂ and P decreased， serum FSH and the expression of OXA protein in TMN region increased， the optical density of ERα and ERβ in TMN region decreased， and the optical density of OXA increased （P＜0.05 or P＜0.01）. Compared with the model group， the sleep latency of the mice in the low-， middle-， and high-dose Gengxin Decoction groups and the zopiclone group shortened， the sleep duration prolonged （P＜0.01）； the serum E₂ and P in the middle-， and high-dose Gengxin Decoction groups increased， FSH and the expression of OXA protein in TMN area decreased （P＜0.05）； the optical density values of ERα in TMN area increased in the medium-dose group， and the optical density value of OXA decreased in low- and middle-dose Gengxin Decoction groups， and the optical density values of ERβ in TMN area increased in low-， middle-， and high-dose Gengxin Decoction groups and the zopiclone group （P＜0.05 ）. Compared with the zopiclone group， mice in the low-dose Gengxin Decoction group had longer sleep latency and shorter sleep duration， and mice in the middle- and high-dose Gengxin Decoction groups had higher serum E₂ level and ERβ optical density value in the TMN area， and lower serum FSH and OXA level in the TMN area （P＜0.05）. Compared with the low-dose Gengxin Decoction group， the sleep latency of mice in the middle- and high-dose Gengxin Decoction groups shortened， and the serum FSH level reduced （P＜0.01）. ConclusionGengxin Decoction may inhibit arousal and improve perimenopausal insomnia by modulating the distribution of estrogen receptors and OXA in the TMN region， and inhibiting the overactivation of the orexin system in the TMN region.

Infant nutritional status evaluation is a basic experimental skill in the experimental teaching of nutrition and food hygiene. The construction of this virtual simulation experiment can solve the problems of activeness and poor coordination of infants and young children in the actual operation of the experiment. And based on the application of this virtual simulation project, the experimental teaching method of preventive medicine was explored. This experiment adopted online and offline mixed teaching method, which enriches teaching measures and strengthens the standardized process of infant nutritional status evaluation. After 3 semesters of practice from spring 2018 to spring 2020, the proportion of students who achieved excellent grades was 30.09% (34/113), 56.02% (279/498) and 66.79% (1 080/1 617), respectively, which increased significantly year by year ( Ptrend < 0.001). Among all the 2 228 students, 1 983 students (89%) believed that this experimental teaching could better cultivate the ability of autonomous learning. Through the study of virtual simulation experiments, students have improved their subjective initiative, and laid a foundation for the improvement of students' overall quality and the requirements of school elite education.

Objective To investigate the structural changes during the early stage of spinal cord injury,and the relationships between these structural changes and patients' motor recovery.Methods The clinical data of 25 patients with spinal cord injury collected from 2012 October to 2014 March were analyzed retrospectively.The spinal cord injury patients were split into two groups (Good recoverers group and Poor recoverers group) according to the clinical outcome of motor recovery at 6 months follow-up,and there were 10 Good recoverers (ASIA grade:1 A,4 B,3 C,and 2 D) and 15 Poor recoverers (ASIA grade:7 A,3 B,3 C,and 2 D).The study also recruited 25 matched healthy controls.The mean age of Good recoverers,Poor recoverers and healthy controls were 37.9± 13.9,35.8± 11.5 and 36.5±9.3,respectively.Structural MRI was used to investigate the regions with brain structural changes among the three groups.Pearson correlation analysis was used to explore the relationships between these structural changes and patients' motor recovery.Results Compared to healthy controls group,both poor recoverers and good recoverers had significantly decreased cortical thickness in the bilateral primary motor cortex.Poor recoverers exhibited more serious and widespread structural damages,in addition to reduced cortical thickness in the primary motor cortex,poor recoverers also showed decreased cortical thickness in the right SMA and premotor cortex when compared to healthy controls.Compared to the healthy controls group,poor recoverers showed reduced white matter volume in the right primary motor cortex and posterior limb of the internal capsule;good recoverers showed no significant difference in white matter microstructure.Furthermore,these structural changes at the internal capsule and primary motor cortex were associated with the motor recovery rate at 6 months follow-up (r=0.75,P＜ 0.001;r=0.76,P＜ 0.001,respectively).Conclusion These findings suggest that spinal cord injury causes significant anatomical changes in the human sensorimotor system in the early phase,and these structural changes directly affect the motor recovery of spinal cord injury.Future treatment aimed at promoting neural function recovery of spinal cord injury patients should pay close attention to the injured brain.

Objective To explore the strategy and outcomes of surgical treatment of thoracic ossification of ligamentum flavum(OLF),especially combined with ossification of posterior longitudinal ligament,thoracic kyphosis and epidural adhesion.Methods Fifty-three cases of thoracic OLF from January 2003 to December 2009 were reviewed retrospectively.All patients were treated by the methods of en bloc resection of semi-facet and lamina.All patients were followed up for more than half an year,including 32 males and 21 females,aged from 43 to 73 years(average 54.7 years).The lesions located in upper thoracic for 18 patients,and in thoracolumbar for 35 patients.For multi-level or jumping OLF patients,the responsible levels were determined by combination of images and clinical symptoms.For multi-level OLF with ossification of posterior longitudinal ligament(OPLL)or thoracic kyphosis(＞50°),multi-level pedicle screw fixation and correction of kyphosis were performed.For dural adhesion patients,part of cerebrospinal fluid was released with a caudal incision of dural sac resulting in collapse and epidural arachnoid separation.Ossific and adhesion dura mater were removed with integrity of arachnoid.The surgical outcomes were evaluated with preoperative and postoperative thoracic Japanese Orthopaedic Association(JOA)score,Nurick grade and neurologic functional recovery ratio.Results Fifty-three cases were followed up for 6 months to 6 years,with an average of 18 months.The average preoperative JOA score was 4.3±2.3,which significantly increased to 8.3±1.8 after operation.Postoperative neurologic functional recovery rates were 11% to 80%(average 65.8%),including excellent in 18 cases,good in 20,fair in 10,and poor in 5.The excellent or good rate was 71.7%.The mean preoperative Nurick grade was 3.7(2-5 grade)and decreased to 2.3 grade after operation.Conclusion En bloc resection of semi-facet and lamina is a safe and effective method for treatment of thoracic OLF.For the patients with OPLL or kyphosis,pedicle screws fixation and kyphosis correction was beneficial for recovery of neurologic function of thoracic OLF patients.

0.5). However, when the flexible bronchoscope was used, foreign bodies dropped into the esophagus in 5 patients. Conclusion The characteristic manifestations was not frequent in the patients with larynx and trachea foreign bodies.History of aspiration was the most sensitive diagnostic tool. The plain chest radiography and fluoroscopy had low positive finding.Therefore, fiberoptic bronchoscopic examination should be performed timely.However, for extraction of foreign bodies, rigid bronchoscope would be the first choice.

ObjectiveTo construct the eukaryotic coexpression plasmid CEA/IL-2, and to lay the foundation for further studying CEA nucleiotide vaccine , adjuvant and their effects of special antitumor immunity.MethodsThe eukaryotic expression plasmid (pcDNA3-CEA)containing the gene coding for CEA was obtained by RT-PCR and gene recombination techniques.Using enzymolysis,ligation and other techniques,an eukaryotic coexpression plasmid (pIRES-CEA/IL-2)containing two expression unites of CEA and IL-2 gene connected with internal ribosome site was constructed.ResultsThe coexpression plasmids were transformed into COS7 cells and expression of two proteins were demonstrated by ELISA, and flow cytometer and elecsy.CEA and IL-2 were (23.73?0.26)ng/ml,and(20.17?0.13)ng/ml respectively.ConclusionsThe eukaryotic expression plasmids pIRES-CEA/IL-2 could be successfully constructed and transformed into COS7 cells.Expression of two proteins were demonstrated with no difference on expression.