ObjectiveTo investigate the effect and mechanisms of rostral ventrolateral medulla (RVL) on the pressor response of lateral hypothalamus-perifornical region (LH/PF) in rats.Methods30 healthy Wistar rats were randomly divided into four groups: the phentolamine group; propranolol group; atropine group and glutamate diethyl ester group, saline was as the control in every group. After microinjection of Glu into LH/PF, the blood pressure and heart rate were observed. Then phentolamine, propranolol, atropine and glutamate diethyl ester were microinjected into RVL and the blood pressure and heart rate changes induced by microinjection of Glu were observed again.ResultsMicroinjection of Glu into LH/PF can cause the blood pressure elevating and heart rate accelerating. The pressor response of Glu to excited LH/PF could be attenuated after response of phentolamine, propranolol, atropine and glutamate diethyl ester microinjected into RVL. The blood pressures of phentolamine group; propranolol group; atropine group and glutamate diethyl ester group reduced significantly different from those in the saline control group (P<0.01).ConclusionThe α-,β-,M- and Glu-receptors in the RVL induce the pressor response of LH/PF region.

The percent of N and C composition in spores or sporocarps of different species of two genera of VA mycorrhizal fungi—Gloraus and Sclerocystis were analysed. It was found that culture period effects the percent of N,C and their ratio, although the influences of host and origin of strain of fungi on those appeared to be low. N,C percentage and their ratio in spores or sporocarps were variable among fungal species of a same genus, but difference between two genera was significantly. This technology may serve as a supplementary indicator for classification and identification of VA mycorrhizal fungi.

Objective To evaluate the protective effectiveness of intranasal immunizations with recombinated-pneumococcal autolysin(Re-LytA), which protects mice against local and systemic Streptococ- cus pneumoniae(Sp) infection. Methods Testing group (group A): CpG as an adjuvant, the mice were intranasally immunized with purified Re-LytA, obtained by affinity chromatograph. The negative control group(group B) were intranasally immunized with sterile saline. And the positive control group (group C) were received 23-valent polysaccharide commercial vaccine through intramuscular injection. All the samples were collected 2 weeks post the last immunization. The levels of antibody was determined by ELISA. Then the mice were challenged intraperitoneally and intranasally with Sp, respectively. The infection and coloniza- tion was followed by monitoring colony-forming units of Sp in the blood, homogenized lung, and nasopharyn- geal lavage fluid 4 days post intranasal immunization. The mice were observed daily to note the livability of each group. Results The level of the LytA antibody (IgG, IgA, slgA) in group A were higher than that in group B and C (P < 0.05). Neither the LytA nor polysaccharide antibody could be detected in group B. Polysaccharide antibody could be detected in group C. After challenged intraperitoneally there was no signifi- cant difference in survival rates between group A and group C (P > 0.05), which was significant higher than that in group B (P <0.05). After challenged intranasally, compared with the group A, the geometric mean colony-forming units washed from the nasopharyngeal lavage fluid of the group B and group C were signifi- cantly higher (P <0.05). Conclusion lntranasal immunizations with Re-LytA can protect mice against lo- cal and systemic pneumococcal infection, and the protective immunity may be related to sIgA.

Objective A surface feedback-stimulation gastric-pacing device was designed to extract gastric surface information,determine the status of gastric and surface stimulation.Methods The characteristic parameters of gastric electrical formed by processing signal and extracting parameter.By that,the state of stomach could be confirmed,and stimulus signal of stomach pace-making in different frequency and intensity could be decided as needed.During the processes of the stimulation,the variations of gastric electrical parameters can be analyzed in real-time and the stimulation parameters could be modified to achieve the self-feedback mode.Results Self-feedback model in different gastric motility analog environment could be realized.Conclusion The preliminary validation of experimental results proved the effectiveness of self-feedback of gastric pacing devices and its application prospects in some areas.

ObjectiveTo investigate the effect of out-patient training combined with family training under doctor's instructions on children with cerebral palsy (CP).Methods80 CP children were selected as treatment group and trained one to three months by therapists at out-patient department, then continually trained at family by parents who received doctor's instructions 30 min once every two or three months. 60 CP children in hospital were selected as control group. Rehabilitative effects of two groups were compared.ResultsIn the first and third month after training completed, movement growth of treatment group was not different from that of control group (P>0.05), but in the sixth month, was significant different from that of control group (P<0.05). The effect of treatment group was better than that of control group.ConclusionOut-patient training combined with family training under doctor's instructions can decrease treatment expenses, and is convenient and effective for CP children.

Objective To explore the clinical characteristics of mycoplasma pneumonia with pulmonary atelectasis and lavage interventional effect through fiberoptic bronchoscopy in children.Methods During Jun 2012 to Apr 2013,fifty-three children diagnosed of mycoplasma pneumonia with pulmonary atelectasis who received fiberoptic bronchoscopy were enrolled as the experimental group.Thirty-five children diagnosed of mycoplasma pneumonia without pulmonary atelectasis were chosen as control group.According to the lavage interventional time of fiberoptic bronchoscopy,we divided the patients in the experimental group into two groups,the early group and late group.Clinical data and laboratory finds were collected and analyzed.Results The duration of fever,hospital stay and C-reactive protein (CRP) of the experimental group were significantly higher than those of the control group (P ＜ 0.05).The location of pulmonary atelectasis in the experimental group were usually in the right middle lobe (18 cases,33.9％).Under fiberoptic bronchoscope,all patients had obviously bronchial mucosa congestive edema.Some of them had follicular hyperplasia (9 cases,17.0％),mucosal erosion (3 cases,5.7％),mucus plug formation (7 cases,13.2％) and poor ventilation of segmental bronchi (4 cases,7.5 ％).Neutrophils (43 cases,81.1％) increased and phagocytic cells (31 cases,58.5％) dereased obviously in bronchoalevolar lavage fluid.After treatment in the experimental group,52 children (98.1％) got complete recruitment of atelectasis.The average duration of fever and hospital stay of the early group were significantly shoter than those of late group (P ＜ 0.05).Conclusion Children diagnosed of mycoplasma pneumonia with pulmonary atelectasis had longer fever duration and higher CRP level.Bronchoscopic interventional therapy promoted the recovery of pulmonary atelectasis.Using bronchoscop early in shorten the duration of fever and hospitalization in children diagnosed of mycoplasm pneumonia with pulmonary atelectasis.

ObjectiveTo analyze the genotype and variation ofMycoplasma pneumonia (MP) strains isolated from chil-dren with MP infection in Soochow area.MethodsThe nasopharyngeal secretions from hospitalized children with MP infection were collected during January 2012 and December 2013. The nested-multiplex PCR based on MPP1 gene was performed to detect the subtype ofMP gene.ResultsIn 313 samples, 304 (97.12 %) samples were classiifed as P1-I type and 8 (2.56%) sam-ples were classiifed as P1-II type and one (0.32%) was V2 variant. Gene sequencing results were consistent with nested-multiple PCR results.ConclusionsNested-multiplex PCR is a reliable method for genotyping of MPP1 gene. During the study period, P1-I type was the common genotype and only one case of V2 variant was found.

OBJECTIVE To re-evaluate systematic review/meta-analysis of escitalopram in the treatment of depression， and to provide reference for clinical use of escitalopram. METHODS Retrieved from CNKI， Wanfang database， VIP， SinoMed， PubMed and the Cochrane Library， etc.， systematic review/meta-analysis of escitalopram in the treatment of depression were collected from the construction of the database to May 17， 2022. The literatures were screened according to the inclusion and exclusion criteria， the basic information of the included literatures was extracted， and the methodological quality， reporting quality and evidence quality of the included literatures were evaluated by using AMSTAR 2 scale， PRISMA statement， and GRADE system， respectively. RESULTS A total of 16 systematic reviews/meta-analyses were included. The results of efficacy comparison showed that escitalopram in the treatment of depression was superior to sertraline in improving the total effective rate， and was comparable to paroxetine， duloxetine and fluoxetine in improving cure rate. The results of safety comparison showed that the safety of escitalopram was higher than that of paroxetine and venlafaxine. The overall methodological quality evaluation of AMSTAR 2 scale was low， and all of them were rated as extremely low； main reason was the lack of many key items. PRISMA score was between 12 and 23 points. Among them， there were 5 literatures with scores ＞21 points， and the reports were relatively complete， 10 literatures with scores between 15 and 21 points， and the reports had certain defects， and 1 literature with scores ≤15 points， with serious information missing. The results of the grading of GRADE evidence showed that， of the 160 included outcome indicators， 69 were moderate evidence， 64 were low-level evidence， and 27 were very low-level evidence. CONCLUSIONS The total effective rate of escitalopram in improving depressive patients is not inferior to that of sertraline； compared with paroxetine， escitalopram is safer. However， the evidence level of the above conclusions is low.

Objective To establish a reasonable evaluation system of the training effect of residents and professional master degree graduates in order to meet the needs of the construction of medical education system.Methods A questionnaire study had been conducted by stratified sampling to evaluate the abilities of the residents and medical professional degree graduates who had finished residency training in Beijing from 2015 to 2016.The trainees were evaluated by themselves,their colleagues and patients they had dealt with.Results The results showed that 95.29％ of the trainees and 99.00％ of their colleagues or patients thought that the overall abilities of the trainees were "excellent" or "better",and the evaluation results of all kinds of personnel above were consistent.Statistical analysis showed that some of the sub items of each ability index were evaluated better than the others,such as professional ethics,team cooperation ability and interpersonal communication ability,while some of the sub abilities need to be improved such as the information and management ability as well as teaching and research ability.The comparative analysis indicated that the postgraduates were superior to the residents in abilities of clinical diagnosis and treatment,information and management ability,and teaching and research ability.Conclusion The study showed that the training effect of residents and professional degree graduates had met the basic requirements,but the comprehensive quality and innovation ability needs to be promoted.The combination of degree education and resident training helps to cultivate the comprehensive ability of medical talents.

Objective:To analyze the construction and operation of the 19th Hangzhou Asian Games designated hospitals, and to discuss the medical emergency security work of large-scale sports events, so as to provide references for the planning of designated hospitals in future large-scale sports events.Methods:Retrospective analysis was made on the establishment principles, requirements, selection of medical support personnel, and training exercises of the designated hospitals, focusing on the key links such as organizational system, staffing, designated areas, and drug management.Results:Total of 40 designated hospitals have successfully completed the task of medical security by rebuilding the medical security area of the Asian Games, elevating the process, equipping facilities, and strengthening staff training. During the Asian Games, 349 people were transferred to designated hospitals by ambulance, 54 people were hospitalized, 19 people underwent surgery, and 1022 people went to designated hospitals by themselves.Conclusion:The construction of the designated hospitals during the 19th Hangzhou Asian Games was of high quality, efficient and smooth operation. It is suggested that efforts should be made in the reconstruction of the medical security area for the Asian Games to be "relatively independent". The treatment process of self-visiting patients should be fully considered and the flat urgent emergency response mechanism needs to be established.