Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Objective:To analyze the antimicrobial resistance and genomic characteristics of Salmonella typhimurium and its monophasic variants isolated from human and food sources in Hangzhou. Methods:A total of 186 Salmonella typhimurium and its monophasic variants isolated in Hangzhou during the period from 2017 to 2021 were subjected to antimicrobial susceptibility testing and whole-genome sequencing, and the genomes from public databases were downloaded. Multilocus sequence typing and the identification of antimicrobial resistance (AMR) genes were performed using the sequencing data. Phylogenetic tree based on the single nucleotide polymorphism (SNP) sites in the genomes from Hangzhou and public databases was constructed. Results:The multidrug resistance (MDR) rate of the monophasic variant strains in Hangzhou was 95.4% (103/108). The MDR strains harbored ≥3 classes of AMR genes simultaneously and the most common resistance genotype was blaTEM-1B- tet( B)- sul2- aac(6′)- Ia (44.7%, 46/103). The MDR rate of Salmonella typhimurium strains was 75.6% (59/78), and 52.5% (31/59) of the MDR strains harbored ≥10 AMR genes simultaneously, with the most common resistance genotype being blaTEM-1B- qnrS1- tet( A)- tet( M)- cmlA1- floR- dfrA12- sul2- sul3- aac(6′)- Iaa (40.7%, 24/59). All of the 186 strains were positive for AMR gene aac (6 ′)- Iaa, and three monophasic variant strains which were resistant to polymyxin E was positive for mcr-1.1. ST19 accounted for 91.0% of the 78 Salmonella typhimurium strains (except for two strains belonging to ST34, two strains belonging to ST1544, and three strains untyped), and ST34 accounted for 96.3% of the 108 monophasic variant strains (except for four strains untyped). The phylogenetic tree showed that the ST19 strains dominated by serotype typhimurium and the ST34 strains dominated by monophasic variants were divided into two clades. In the ST19 clade, strains from Hangzhou were mainly clustered with the strains from other cities in Zhejiang Province as well as other provinces and cities in China, such as Jiangxi, Shanghai, and Shandong. Strains isolated from pig, duck, and chicken were the ones that were clustered with clinical strains. In the ST34 clade, most strains from Hangzhou were clustered together, and some strains were clustered with those isolated from other cities in Zhejiang Province as well as Beijing, Guangdong, Shanghai, etc. Strains isolated from pig and chicken were the ones that were clustered with clinical strains. Conclusions:The MDR rate of monophasic variant strains is higher than that of Salmonella typhimurium strains, and the latter is prominent by its harboring multiple AMR genes. The epidemic of Salmonella typhimurium and its monophasic variants in Hangzhou is mainly caused by the spread of ST19 and ST34 strains, respectively, and the clinical infection may be closely related to the consumption of pork and poultry meat. While transmitting locally, cross-region transmission of the two serovars in Zhejiang Province and cross-province transmission in China may also occur.

Objective:To analyze the antimicrobial resistance and genomic characteristics of Salmonella typhimurium and its monophasic variants isolated from human and food sources in Hangzhou. Methods:A total of 186 Salmonella typhimurium and its monophasic variants isolated in Hangzhou during the period from 2017 to 2021 were subjected to antimicrobial susceptibility testing and whole-genome sequencing, and the genomes from public databases were downloaded. Multilocus sequence typing and the identification of antimicrobial resistance (AMR) genes were performed using the sequencing data. Phylogenetic tree based on the single nucleotide polymorphism (SNP) sites in the genomes from Hangzhou and public databases was constructed. Results:The multidrug resistance (MDR) rate of the monophasic variant strains in Hangzhou was 95.4% (103/108). The MDR strains harbored ≥3 classes of AMR genes simultaneously and the most common resistance genotype was blaTEM-1B- tet( B)- sul2- aac(6′)- Ia (44.7%, 46/103). The MDR rate of Salmonella typhimurium strains was 75.6% (59/78), and 52.5% (31/59) of the MDR strains harbored ≥10 AMR genes simultaneously, with the most common resistance genotype being blaTEM-1B- qnrS1- tet( A)- tet( M)- cmlA1- floR- dfrA12- sul2- sul3- aac(6′)- Iaa (40.7%, 24/59). All of the 186 strains were positive for AMR gene aac (6 ′)- Iaa, and three monophasic variant strains which were resistant to polymyxin E was positive for mcr-1.1. ST19 accounted for 91.0% of the 78 Salmonella typhimurium strains (except for two strains belonging to ST34, two strains belonging to ST1544, and three strains untyped), and ST34 accounted for 96.3% of the 108 monophasic variant strains (except for four strains untyped). The phylogenetic tree showed that the ST19 strains dominated by serotype typhimurium and the ST34 strains dominated by monophasic variants were divided into two clades. In the ST19 clade, strains from Hangzhou were mainly clustered with the strains from other cities in Zhejiang Province as well as other provinces and cities in China, such as Jiangxi, Shanghai, and Shandong. Strains isolated from pig, duck, and chicken were the ones that were clustered with clinical strains. In the ST34 clade, most strains from Hangzhou were clustered together, and some strains were clustered with those isolated from other cities in Zhejiang Province as well as Beijing, Guangdong, Shanghai, etc. Strains isolated from pig and chicken were the ones that were clustered with clinical strains. Conclusions:The MDR rate of monophasic variant strains is higher than that of Salmonella typhimurium strains, and the latter is prominent by its harboring multiple AMR genes. The epidemic of Salmonella typhimurium and its monophasic variants in Hangzhou is mainly caused by the spread of ST19 and ST34 strains, respectively, and the clinical infection may be closely related to the consumption of pork and poultry meat. While transmitting locally, cross-region transmission of the two serovars in Zhejiang Province and cross-province transmission in China may also occur.

Objective To observe the effects of total flavones from Herba Epimedii(TFHE)on the experimental myocardial ischemia and hemorheology of animals.Methods The model of acute myocardial ischemia of rats was established with pituitrin and the model of acute blood stasis was established with high-molecular dextran.The effects of TFHE on the electrocardiogram J-point of acute myocardial ischemia model and the hemorheology of acute blood stasis model were observed.Besides these,the effects of TFHE on coaglutaion time in mice were observed.Results As compared with the model groups,high-,middle-,and low-dosage groups(24,12,and 6 mg/kg)of TFHE could obviously improve the abnormal electrocardiogram J-point of acute myocardial ischemia model,also could effectively prevent the ascending of whole blood viscosity(high-,middle-,and low-shear rate),packed erythrocyte volume,and fibrinogen.High-and low-dosage groups(34 and 17 mg/kg)of TFHE could obviously lengthen the coaglutaion time in mice.Conclusion The results suggest that TFHE possesses protective effects on ischemic myocardium,which may better hemorheology,decrease the whole blood viscosity,prevent blood from coagulating and improve the circulatation of coronary artery.

Aim To investigate effects of Icariin in rats with acute myocardial ischemia induced by isoproterenol(ISO).Methods Icariin(12,6,3 mg?kg-1) was administrated through iv pathway for five days.Myocardial ischemia model of rats was induced by subcutaneous injection(sc) of ISO(30 mg?kg-1 for two days,once a day).The change of Electrocardiogram(ECG) was observed.The levels of lactate dehydrogenase (LDH),superoxide dismutase(SOD), malondialdehyde(MDA) and nitric oxide(NO)in serum were measured.Cardiac indexes(HW/BW and LVW/BW)and cardiac infarction area(IS/V%)were examined.Results Compared with the model group,Icariin(12,6,3 mg?kg-1) could effectively reverse the evident change of T wave and J point induced by isoproterenol,notably decrease the levels of LDH and MDA in the serum, distinctly increase the levels of SOD and NO in the serum(P