Objective: To explore the prevalence of elevated blood pressure and overweight/obesity and their comorbidities among Tibetan middle school students in Lhasa, and to analyze their association with lifestyle and other factors, so as to provide a basis for the intervention measures targeting elevated blood pressure, overweight and obesity among middle school students in high altitude area. Methods: Using a stratified cluster random sampling method in September 2021, a total of 1 488 Tibetan junior and high students from Lhasa City were investigated with blood pressure measurement, physical examination and questionnaire survey. The influencing factors of elevated blood pressure, overweight and obesity and their comorbidities association were analyzed by multivariate Logistic regression. Results: The prevalence of elevated blood pressure, overweight/obesity and their comorbidities were 17.8%, 17.4% , 5.0% respectively. Multivariate Logistic regression analysis showed that age( OR =0.81), residence, body mass inex(BMI) and gender were the influencing factors of elevated blood pressure; and the risks of elevated blood pressure in female students were higher than male students ( OR =1.89), suburban students were higher than urban students ( OR =8.06), overweight and obesity groups were higher than normal groups ( OR =2.55, 2.87) ( P <0.05). Adjusting for confounding factors such as gender, residence and school, and BMI (only for elevated blood pressure), daily screen time ≥2 h was positively correlated with elevated blood pressure, overweight/obesity and its comorbidities ( OR =1.56, 1.59 , 2.51) ( P <0.05). Conclusions The prevalence of elevated blood pressure, overweight/obesity are relatively high in Lhasa. Longer screen time is a common factor affecting with elevated blood pressure, overweight/obesity and comorbidities among Tibetan students. Measures should be taken intervene in the lifestyle of Tibetan students, in order to reduce elevated blood pressure and overweight/obesity.

Objective:To investigate the effects of 2 650 MHz radiofrequency (RF) exposure on the behavior and neurotransmitter release of mice.Methods:Adult male C57BL/6N mice were divided into a normal control (CON) group and a radiofrequency radiation (RFR) group using the random number table method. The mice in the RFR group were subjected to single-dose whole-body exposure to a uniform 2 650 MHz RF electromagnetic field for 3 h. During the RF exposure, the field strength in the effective working area of the RF radiation platform was measured using an electromagnetic radiation analyzer, and the changes in the anal temperature of the mice were monitored using an optical fiber thermometer. Moreover, the changes in the cognition, social interaction, and emotion of the mice were determined through the new object recognition test, social preference test, and open field test. Finally, the changes in the hippocampal neurotransmitter release levels of the mice were detected using microdialysis sampling and mass spectrometry, and the changes in the hippocampal tissue structure and ultrastructure were observed via microscopy.Results:Under the test conditions, RF radiation improved the anal temperature of the mice, with a maximum increasing amplitude of 0.61℃, falling within the range of thermal safety. The mice in the RFR group experienced a significant decrease in the frequency and time for exploring new objects ( t=4.50, 2.53, P < 0.05) in the new object recognition test, a significant decrease in the frequency ( t=0.08, P<0.01) and time ( t=0.03, P<0.05) for exploring other mice in the social preference test, and no significant change in the frequency and time for exploring the central area ( P > 0.05) in the open field test. Compared to the CON group, the RFR group showed an increase in the release of 5-hydroxytryptamine (5-HT) ( t=-2.56, P < 0.05) and a decrease in the release of acetylcholine (ACh) ( t=2.21, P < 0.05), no significant difference in the release of glutamate (Glu) and γ-aminobutyric acid (GABA) ( P > 0.05), and no evident damage to the hippocampal tissue and structure and synaptic ultrastructure. Conclusions:2 650 MHz RF radiation may induce cognitive impairment and abnormal social preference in mice, which is attributed to neuronal dysfunctions and neurotransmitter release disorders under RF exposure.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective To investigate the effect of microglia inhibitor Pexidartinib on reconsolidation of remote contextual fear memory in mice.Methods Twelve healthy C57BL/6 male mice were randomly divided into experimental group and control group,with 6 mice in each group.The mice in the two groups underwent contextual fear conditioning training in the contextual fear response box to establish the contextual fear models,and the freezing time of mice after each footshock was recorded.After 7 days,the mice in the experimental group were fed with food containing Pexidartinib formulation PLX3397,while the mice in the control group were fed with regular food until the end of behavioral experiment.On the 16th day after contextual fear conditioning training,the mice were put back into the contextual fear box for recalling the fear memory without any stimulation.The mice were taken out after 5 minutes of free exploration,and the freezing time of mice during this period was recorded.At 24 h after the fear memory was recalled,the mice were again placed in the contextual fear box,allowing them to explore freely for 3 minutes,and the freezing time of mice during this period was recorded;the fear response of mice was indicated by the percentage of freezing time.After the behavioral experiment,the mice were anesthetized by intraperitoneal injection of pentobarbital sodium,and three mice from the two groups were taken and rapidly opened the chest to expose their hearts,the perfusion needle was inserted into the left ventricle from the tip of heart and then was perfuse with 40 g·L-1 paraformaldehyde(pH=7.4)which precooled at 4 ℃ until the involuntary convulsion disappeared and the body limbs of mice were stiff.The brain tissue of mice was taken and fixed with paraformaldehyde solution,and then placed in sucrose solution for dehydration.The brain tissue of mice was coated with tissue embedding agent.The number of microglial cells in the hippocampus of mice in the two groups was detected by immunohistochemistry.The remaining mice in the two groups were taken and quickly decapitated to obtain brain tissues,and the hippocampus tissues of two sides were separated on ice.The expressions of phosphorylated bromodomain-containing protein 4(pBRD4),gasdermin D(GSDMD)and mixed lineage kinase domain-like protein(MLKL)in the hippocampus of mice were detected by Western blot.Results In the stage of contextual fear conditioning training,the percentage of freezing time of mice in two groups increased with the increase of the number of footshock(P＜0.05),but there was no significant difference in the percentage of freezing time of mice after the first,second,third,fourth and fifth footshock between the two groups(P＞0.05).There was no significant difference in the percentage of freezing time of mice between the two groups during recall period(P＞0.05).The percentage of freezing time of mice in the experimental group was significantly lower than that in the control group at the phase of memory test(P＜0.05).The number of microglia in CA1,CA3 and DG regions of hippocampus of mice in the experimental group was significantly lower than that in the control group(P＜0.05).The relative expressions of pBRD4,GSDMD and MLKL in hippocampus of mice in the experimental group were significantly lower than those in the control group(P＜0.05).Conclusion Microglia inhibitor Pexidartinib can injury the reconsolidation of remote contextual fear memory,which may be related to its inhibition of microglial cell activation and the down-regulation of the expressions of pBRD4,GSDMD and MLKL.

【Objective】 To explore the role of environmental enrichment (EE) in paternal stress-induced anxiety and depression-like behaviors in offspring and its potential mechanisms. 【Methods】 Male C57BL/6 mice (F0) were treated with unpredictable chronic mild stress (UCMS) and subsequently mated with normal females to obtain F1 offspring mice. The standard environment (SE) and enriched environment (EE) were administered to F1-UCMS offspring mice during their early life (3-5 weeks of age). Anxiety-like behaviors were detected by open field test (OFT) and elevated plus-maze test (EPM); depression-like behaviors were detected via forced swimming test (FST) and sucrose preference test (SPT) at the age of 8 weeks. The expressions of LIM and SH3 domain protein 1 (LASP1) in the hippocampus of adult F1 offspring mice were detected by Real-time fluorescence quantitative PCR (RT-qPCR) and Western blotting. 【Results】 Compared to F1 offspring of normal paternal (F1-Nor), F1 offspring mice of the stressed paternal (F1-UCMS) showed significantly anxiety-like behavior with reduced percentage of time spent in the central region of OFT and in the open arm of EPM (P<0.05); mice from the F1-UCMS group showed a significantly increased percentage of immobility in FST and a reduced percentage of sugar consumption in SPT (P<0.01), which demonstrated significant depression-like behaviors. Compared to the SE group, mice in the EE group had an increased percentage of time spent in the central region of the OFT [males: (7.44±0.75)% vs. (14.93±1.74)%, P<0.01; females: (8.89±1.06)% vs. (15.10±1.82)%, P<0.05] and an increased percentage of time in the open arm of EPM [males: (8.09±1.05)% vs. (14.15±1.88)%, P<0.05; females: (9.13±1.14)% vs. (14.04±1.37)%, P<0.05]. This indicated that EE ameliorated anxiety-like behavior in F1-UCMS mice with paternal stress. Compared to the SE group, mice in the EE group had an decreased percentage of immobility in FST [males: (58.63±4.51)% vs. (42.15±3.81)%, P<0.05; females: (57.96±4.19)% vs. (43.25±4.22)%, P<0.05] and an increased percentage of sugar consumption in SPT [males: (50.38±3.47)% vs. (70.39±3.12)%, P<0.01; females: (52.42±2.84)% vs. (69.99±3.55)%, P<0.01]. This indicated that EE ameliorated depression-like behavior in F1-UCMS mice with paternal stress. Hippocampal LASP1 expression was reduced in SE group compared to F1-Nor group (males: P<0.01; females: P<0.05), while LASP1 was increased in EE group compared to SE group (P<0.05) detected by RT-qPCR and Western blotting. 【Conclusion】 EE ameliorates paternal stress-induced anxiety and depression-like behaviors in F1-UCMS mice, and the mechanism may be associated with increased hippocampal LASP1 expression in F1-UCMS mice.

OBJECTIVE To explore and establis h a general pharmacist system suitable for China ’s national conditions ，and to improve the rational use of drugs in primary medical institutions . METHODS Under the leadership of Tianhe District Health Bureau of Guangzhou ，relying on the regional pharmaceutical specialty alliance ，general pharmacist system of medical consortium was established ，and the general pharmacist was responsible for the overall planning of pharmaceutical care in the medical consortium. The joint management office of pharmaceutical care was established ，and the training of the pharmacists in the medical consortium was organized. A regional audit center was established to realize the prescription review of 13 community health service centers in the medical consortium. “Internet plus ”home pharmaceutical care was carried out ，and science popularization education was provided for communities ，schools，enterprises and institutions. RESULTS After systematic training and assessment ，three pharmacist teams had been successfully established in the medical consortium to provide prescription review ，science popularization and education and family pharmacist services for community residents ；the regional audit center successfully intercepted 17.17％ of unreasonable prescriptions ，reducing the amount of unreasonable drug use by a total of 6.56 million yuan. After the intervention of prescription review system ，the qualified rate of outpatient prescriptions in community health service centers was ≥95％，and the qualified rate increased by an average of 6％. The department of pharmaceutical science popularization and education held 35 science popularization and free clinic activities ，of which 71.20％ of the residents believed that the activities had improved their understanding of drugs. In addition ，111 cases patients serviced by home pharmaceutical care were carried out successfully by pharmacist team ，and the patients ’acceptance of pharmacist intervention was 91.89％ . CONCLUSIONS Under the new medical reform ，it is feasible to implement a regional general pharmacist system within the medical consortium ， which improves the pharmaceutical administration and pharmaceuticalcare capabilities of m edical institutions in the medical consortium，as well as the level of rational drug use ，and reduces the me dical burden.

Parkinson's disease (PD) is a neurodegenerative disease characterized by degeneration and deletion of dopaminergic neurons in the substantia nigra and a pathological feature of the Louis body.The clinical manifestations including non motor symptoms and motor symptoms.Cognitive impairment (CI)is one of the most common non motor symptoms in patients with PD,Which includes mild cognitive impairment (MCI) and dementia.MCI is an early manifestation of dementia in PD.Therefore,early diagnosis and treatment of MCI are very important for the prognosis of PD.The epidemiology,risk factors,heredity,biomarkers,imaging,diagnosis and treatment of MCI in PD are reviewed in this paper.

Objective To evaluate the clinical effect of acupuncture on Parkison disease (PD) with systematic review in view of evidence-based medicine (EBM).Methods Articles on clinical effect of acupuncture on Parkinson disease published from the database-established year to May of 2017 we searched from China National Knowledge Internet (CNKI),Wanfang,VIP,Chinese Biomedical Literature Database (CBM),PubMed,and Cochrane Library databases without language limitation.Quality evaluation and data extraction were carried out according to the tool for assessing risk of bias provided by the Cochrane Handbook for Systematic Reviews of Interventions (Version 5.1.0).All statistical analyses were performed with Reviewer Manager Software (Version 5.3;Cochrane Collaboration,Oxford,UK).Assessments were performed with the total effective rate,the scores of each scale (the unified Parkinson disease rating scales-UPDRS and the Webster scale),and the improvement of different clinical manifestation.Results In all,12 randomized controlled trials (RCTs) met our inclusion criterion,a total of 892 patients,including 468 cases in the experimental group (acupunctuer with or without medicine) and 424 cases in the control group (medicine only).Meta-analysis showed favorable results for the experimental group compared to control group in the total effective rate,the total scales of UPDRS and the modified Webster scale [OR =2.16,95％ CI (1.57,2.97),P＜0.01;OR =7.20,95％ CI(4.02,10.37),P＜0.01;OR=3.33,95％ CI(2.13,4.53),P ＜0.01].The experimental group was effective in relieving partial symptoms of PD such as rigidity,postural,gait,bradykinesia compared to the control group,while there was no significant difference in tremor at rest and sit-stand up movements (P ＞ 0.05).Conclusions Acupuncture had certain clinical effect on Parkinson disease,it can relieve the clinical symptoms of Parkinson disease to some extent,and postpone the progression of PD,which improves the quality of life of PD patients.Acupuncture can be recommended as a combination treatment for Parkinson disease.

The delta-opioid receptor (DOR),which is a classic analgesic drug widely existed in the central system and peripheral system,is a kind of inhibitory G-protein coupled receptor with seven transmembrane regions.In addition to pain modulation,the opioid receptors are involved in various physiological and pathological activities through gene or cytokines.This review addresses the influence and possible mechanisms of the delta-opioid receptor in ischemic brain injury,analgesia,anti-anxiety and depression,learning and memory,and Parkinson's disease.

Objective To observe the clinical features of senile patients suffering from fungemia of Candida parapsilosis, and the effect and safety of antifungal therapy in treatment of this disease in geriatric intensive care unit (GICU). Methods The clinical data of patients with fungi positive either in peripheral blood culture or catheter culture admitted to the GICU of Tianjin Medical University General Hospital from November 2012 to June 2015 were retrospectively analyzed, of them 45 cases were of infection of Candida parapsilosis (parapsilosis group) and 15 cases infection of non-Candida parapsilosis (non-parapsilosis group). The clinical features of the two groups were collected, such as sex, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, sequential organ failure assessment (SOFA) score, timing of antifungal therapy, number of patients mechanical ventilation, concomitant disease, catheter-related infection, method of catheter-indwelling, levels of creatinine (Cr), hemoglobin (Hb), platelet count (PLT), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), etc.; the differences in above indicators were compared between the two groups; multifactor Cox-regression-analysis was used to analyze the risk factors that could affect the patients' prognosis; the patients' survival rates on 7, 14 and 28-day were calculated and compared between the two groups, and the therapeutic effects of different anti-fungal drugs on patients' survival rates and liver function damage were recorded and compared. Results The non-parapsilosis group had a higher rate in mechanical ventilation than parapsilosis group [73.3% (11/15) vs. 33.3% (15/45), P < 0.05], and in the comparisons of other clinical features, there were no statistical significant differences between the two groups (all P > 0.05). There were no statistical significant differences in survival rates in the duration of 7, 14 and 28 days between the two groups[7 days: 82.2% (37/45) vs. 66.7% (10/15), 14 days: 75.6% (34/45) vs. 60.0% (9/15), 28 days: 66.7% (30/45) vs. 46.7% (7/15), all P > 0.05]. When the patients in parapsilosis group treated with echinocinomycin were compared with those treated with azolol, no statistical significant differences were found between the 2 types of therapy in the survival rates in the duration of 7, 14, and 28 days after treatment [7 days: 100.0% (23/23) vs. 82.4% (14/17), 14 days: 91.3% (21/23) vs. 76.5% (13/17), 28 days: 78.3% (18/23) vs. 70.6% (12/17), all P > 0.05]. Multifactor Cox-regression-analyses showed:diabetes [odds ratio (OR) = 0.268, 95% confidence interval (95%CI) = 0.077 - 0.928, P = 0.038), infection of Candida parapsilosis (OR = 0.260, 95%CI = 0.072 - 0.946, P = 0.041), APACHE Ⅱ score (OR = 1.241, 95%CI = 1.051 - 1.466, P = 0.011) and SOFA score (OR = 1.405, 95%CI = 1.005 - 1.966, P = 0.047) were the risk factors affecting the prognosis of the patients. When the patients in parapsilosis group treated with echinocinomycin were compared with those treated with azolol, there were no statistical significant differences in incidences of aggravation of liver damage and newly developed liver damage (aggravation of liver damage: 18.8% vs. 21.0%, newly developed liver damage: 6.2% vs. 10.5%, both P > 0.05). Conclusion The patients with fungemia in GICU are mainly the infection of Candida parapsilosis, and diabetes, infection of parapsilosis, APACHE Ⅱ score and SOFA score are the risk factors affecting the prognosis of the patients.