Objective To investigate the clinical features of Escherichia coli pneumonia, the positive rate of extend-spectrumβ-lactamase (ESBLs) produced by Escherichia coli and antimicrobial resistance of Escherichia coli. Methods Three hundred and thirty-six infants with Escherichia coli pneumonia were divided into community acquired infection group and hos-pital acquired infection group from Jun 2003 to Jun 2013. The clinical data of those patients were collected and analyzed. The ESBLs were examined, and drug susceptibility results were analyzed. Results Infants under 6 months had higher infective rate of Escherichia coli. The Escherichia coli pneumonia had similar clinical manifestations as Gram negative bacterial pneumonia. ESBLs were found in most strains (58.3%, 196/336), positive rate of ESBLs of hospital acquired infection group (84.00%) was higher than that of community acquired infection group (50.96%) (χ2=26.17, P<0.05). There was no difference of ESBLs posi-tive rate between the community acquired infection groups during Jun 2003-May 2008 and those during Jun 2008-Jun 2013 (χ2=0.30, P>0.05). The ESBLs positive rate of hospital acquired infection group was significantly increased from 76.74%(Jun 2003-May 2008) to 93.75% (Jun 2008-Jun 2013) (χ2=3.95, P<0.05). The most sensitive antibiotic was carbapenem. Conclusions Escherichia coli pneumonia mainly occurs in infants, usually with severe clinical situations and more persistent. The hospital acquired infection is the high risk factor of acquiring ESBLs. Antibiotics should be prescribed depending on community acquired infection or hospital acquired infection.

The result of medical licensing examination is an objective reflection of the quality of medical education. The average scores and pass rates of medical licensing examination of the military medical university including The Third Military Medical University, were under the national average levels, which made us find the problems, therefore, reflection on curriculum structure, teaching method, administration mode and continuing education should be integrated to the requirement of the medical licensing examination, so as to let the students meet the complex demand of the society, as well as the special requirement of military service.

National Natural Science Foundation of China (NSFC) is an important part of national system for innovation, which provides financial assistance mainly for the basic and applied researches of natural sciences, especially for the researchers who work in the learning institutions and the agencies of scientific research with advanced facilities. This paper summarized the applications and approved projects on traditional Chinese medicine in NFSC in 2005. We initially analyzed the growth, quality, characteristics, tendency and problems of these items.

This paper briefly introduced the development course, present situation and characteris-tics of United States Medical Licensing Clinical skills examination. Based on the elaboration of four key elements, namely organization and management, subjects setting, method and form, and evaluation method-ology, we analyzed the advantages and disadvantages, to provide experiences and references for improving and perfecting our country's Medical Licensing Clinical skills examination.

In this paper,the constitute elements of Sino-US licensed doctors' practical skill examination evaluation index system are expounded.Through comparison,the differences on the formulation basis,classification principle,test content,and ability requirements are inferred;On the basis of referring to the advanced experience and practice of the United States,and by combining the requirements of the most basic requirements of global medical education,suggestions for improving the Chinese licensed doctors' practical skill examination evaluation index system are proposed in terms of integrating the test syllabus classification,adjusting the distribution of clinical practice ability examination content,increasing the proportion of medical humanities content test,as well as establishing a scientific examination evaluation index weight table.

Objective To explore the epidemiologic and clinical features of hand, foot and mouth disease (HFMD) caused by Coxsackie virus A16 (CA16) in Suzhou from 2010 to 2014, and analyze the relationship between the SNPs of oligoadenylate synthetase 1 (OAS1) and HFMD caused by CA16 infection.MethodsThe clinical data of children diagnosed with HFMD caused by CA16 during 2010 and 2014 were collected. The epidemiological characteristics were analyzed. Among them, 167 cases were selected to make comparison of the clinical features with 166 cases of HFMD caused by EV71 infection in the same period. The genotyping ofOAS1 rs10774671 was detected by TaqMan probe technique in 167 cases of CA16 infection children, 166 cases of EV71 infection children with HFMD and 163 healthy children. The relationship between polymorphism of gene and infection of CA 16 was analyzed.ResultsA total of 9 016 children with HFMD were included. CA16 nucleic acid detected to be positive in 762 cases. The detection rate was 8.45%. CA16 infection was most commonly in summer. Children under 5 years old accounted for 94.62% infected. Compared with EV71 infected children, CA16 infected children had shorter fever time, severer oral herpes, ulcer, and rash in hand, foot and hip, lesser nervous system involvement, fewer cases of high lactate dehydrogenase, high C reactive protein, high IgM or IgG, and signiifcant changes in the percentage of CD3+, CD3+CD4+, CD3+CD8+ and CD3-CD19+ (P all?

OBJECTIVE:To study the genetic diversity of germplasm resources of Duchesnea indica from Hunan. METHODS:The random amplified polymorphic DNA(RAPD)reaction system of germplasm resources was established and RAPD-PCR was ad-opted to detect the expressions of 24 groups of D. indica from Hunan(including 21 wild and 3 cultivated varietos in different geo-graphical distribution). Agarose gel electrophoresis was used to analyze the results and calculate allele number (Na),effective al-lele number (Ne) the polymorphism points percentage (PPB),Nei’s gene diversity index (H) and Shannon’s information index (I). RESULTS:Totally 14 polymorphic primers were screened and 90 electrophoresis bands were amplified,including 81 polymor-phic bands with Na of 1.900 0,Ne of 1.540 1,PPB of 90.0%,H of 0.312 8 and I of 0.467 5. CONCLUSIONS:The genetic diver-sity of D. indica from Hunan is rich,and there were differences in genetic background between the cultivated species and wild spe-cies;clustering results show significant correlation with geographic distribution.

Objective To evaluate the effects of hyperbaric oxygen (HBO) combined with drug therapy on patients with delayed encephalopathy caused by carbon monoxide poisoning ( COP). Methods Twenty to forty sessions of HBO therapy were used to treat 34 COP patients. Assessment relied on 99mTc-ethyl cysteinate dimer (~(99m)Tc-ECD) single photon emission computed tomography (SPECT) imaging of cerebral perfusion before and after treatment. Results After HBO therapy, cerebral perfusion in the COP patients improved significantly. There was a significant difference of the SPECT images before and after treatment. Conclusions SPECT imaging of cerebral perfusion can play an important role in the diagnosis of delayed encephalopathy caused by carbon monoxide poisoning, and it can be used for the therapeutic surveillance of HBO treatment.

Objective To evaluate the clinical efficacy of oral taking traditional Chinese medicine with functions of tonifying kidney, nourishing blood and soothing liver and external application treatment of premature ovarian failure(POF). Methods 40 patients of deficiency of liver-yin and kidney-yin type POF in Gynecology Department of Xiyuan Hospital CACMS from July 2009 to July 2013 were collected and administrated with traditional Chinese medicine with functions of tonifying kidney, nourishing blood and soothing liver and external treatment for 3 months. The changes of menstruation situation, symptoms and serum sex hormone were compared before and after the treatment. Results ① Menstruation integral were reduced after the treatment, showing a statistical significance compared with those before the treatment(t=5.694,P<0.01). ② Symptoms integral were reduced after the treatment, showing a statistical significance compared with those before the treatment(t=21.828,P<0.01). ③ Serum FSH, LH were decreased and Serum E2 were increased after the treatment,showing a statistical significance compared with those before the treatment(P<0.05). ④ The total effective rate was 92.5%(37/40). Conclusion Traditional Chinese medicine with functions of tonifying kidney, nourishing blood and soothing liver are effective for treating POF. These methods had proven to improve ovarian function by decreasing high level of FSH and LH, whereas enhancing the estrogen level, and therefore promote menstruation cycle.

Objective To optimize extraction process of flavonoids from Toosendan Fructus.Methods Three parameters that significantly affect the extraction rate of flavonoids, ratio of material to water, extraction time and ethanol concentration, were taken into consideration for extraction ratio of flavonoids from Toosendan Fructus. Based on the results of single-factor experiment, the extraction parameters of flavonoids from Toosendan Fructus were optimized by Box-Behnken of response surface methodology (RSM).Results The optimum extraction conditions were as follow: material to water ratio was 1:35; extraction time should be 3 h; ethanol concentration was 70%. The extraction ratio was up to 0.587 3% in the optimum extraction conditions.Conclusion The actual value is highly matching the theoretically value of RSM model. The results indicated that this method can rationally optimize extraction process of flavonoids from Toosendan Fructus.