Preliminary exploration on subject librarian mechanism and service is carried out in college and university libraries in Chi-na. The paper introduces actual needs, implementation modes, service contents and forms of subject librarian service in Library of China Medical University;hopefully the good experience would provide reference to other medical colleges and universities.

Subcortical ischemic vascular disease (SIVD) is considered to be the most important and common cause of vascular cognitive impairment (VCI). If patients with subcortical ischemic vascular cognitive impairment (SIVCI) and subcortical vascular cognitive impairment (sVCI) can be found early, it is possible that vascular dementia (VaD) can be identified before occurrence and even reverse the process. Recent studies have shown that resting-state functional magnetic resonance imaging (rsfMRI) may provide the objective basis for the diagnosis of SIVCI. This article reviews the application of rsfMRI in the diagnosis of SIVCI.

Objective To observe the clinical efficacy and safety of ultrapulse CO 2 laser-assisted au-tologous epidermal grafting for the treatment of vitiligo.Methods1605patients with30660skin grafts were treated by CO 2 laser-assisted autologous epidermal grafting.Among them,782patients had localized vi-tiligo,319segmental,226general and278scattered.Epidermal grafts were harvested with negative pressure blistering method from normally pigmented skin,and recipient areas were prepared with a ultrapulse CO 2 laser.The curative effect was evaluated8weeks later.Results79.04%of the lesions were cured complete-ly,and total response rate was92.21%,with better effect in localized and scattered lesions than in other le-sions.The best results were shown in face,while the worst results shown in brow and hairline lesions.Con-clusions The advantage of combined therapy of CO 2 laser with autologous epidermal grafting in vitiligo is of easy performance,convenience,high response rate,which is worthy of large scale application.

Objective:To study the cytotoxicity to tumor cells P815,H22 and B16 in vitro and the treatment effect of mice spleenocytes activated by lymphokine IL-2 and Tremella Polysaccharide,and their effects on main viscerals.Methods:The cytotoxicity of spleenocytes activated by lymphokine IL-2 or IL-2 and Tremella Polysaccharide to P815,H22 and B16 was detected by ?-scintillation counter after 2 hours.Subcutaneous injection of the above-mentioned spleenocytes to the local area of jepatocarcinoma of mice,one injection every two days,5 times totally.To examine tumor weight,size,histological changes and morphological changes in main viscerals.Results:The significantly cytotoxicity to tumor cells of spleenocytes activated by IL-2 and Tremella Polysaccharide was observed.To B16,the cytotoxicity of activated spleenocytes was the strongest.To H22,the cytotoxicity of activated spleenocytes was stronger and to P815,the cytotoxicity was the weakest,the cytotoxicity of TP-LAK cells was significantly stronger than that of LAK cells( P

RT-PCR, Western blot, and immunofluorescence were used to examine secreted protein acidic and rich in cysteine(SPARC)mRNA and protein expression in adipose tissue of rats. The results showed that the expression levels of SPARC mRNA and protein in adipose tissue of insulin resistant rats were higher than those of the normal ones(all P＜0.01). SPARC may play a role in the negative feedback regulation duning the development of insulin resistance.

A total of 58 patients with simple septic shock were recruited from intensive care unit and divided into control group (n =28) and treatment group (n =30) according to treatment modalities.The control group was routinely treated.The treatment group received continuous veno-venous hemofiltration (CVVH) for 10-14 days plus routine measures.After 3 days,the score of acute physiology and chronic health evaluation-Ⅱ (APACHE-Ⅱ) of the treatment group was better than that of the control group (P ＜ 0.01).And sequential organ failure assessment (SOFA),left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVEDS) and left ventricular ejection fraction (LVEF) improved significantly (P ＜ 0.05).And the relevant blood biochemical parameters improved significantly better than the control group (P ＜ 0.05).In the group CVVH,there were mortality (n =7,23％) and multiple organ failure (MODS) (n =6,20％) ; In the control group,mortality (n =14,50％) and MODS (n =13,46％).The mortality rate had inter-group differences of statistical significance (x2 =4.38,P ＜0.05).Thus early volume resuscitation plus CVVH had excellent curative efficacies for septic shock.

The operating room is the main place of surgery,but there exist many ethical problems when developing quality nursing service in operating rooms.These problems mainly related to the imperfect preoperative and postoperative visit systems,the lack of effective communication and protection of patients privacy during the operations,and the lack of self-discipline spirit.To solve these problems,we should improve the preoperative and postoperative visit system,strengthen the psychological counseling for patients,cultivate the nurses' self-discipline spirit,respect and protect the privacy of patients,so as to improve the quality of nursing service in the operation rooms,and better service for patients.

Objective To determine the peripheral dose ( PD) of a Trilogy accelerator under different conditions and the feasibility of PD measurement using the semiconductor diode ionization chamber. Methods In a solid water phantom, a CC13 air?filled ionization chamber and a semiconductor diode ionization chamber were used for PD measurements with different distances (13 measurement locations within 1?31 cm) , depth ( 3, 5, 15 cm) , field sizes ( 10, 20, 30 cm) , wedge ( W15, W45, VW15, VW45) , and beam energy (6, 18 MV). The relationship of PD with PDleakage and PDscat er was determined by removing the scatter phantom. Simulating the patients with cervical cancer undergoing radiotherapy, a CIRS phantom received volumetric modulated arc therapy ( VMAT) , step?shoot intensity?modulated radiotherapy ( IMRT) , and sliding?window IMRT to measure PDs of the breast, thyroid, and lens. All the data were normalized to the isocenter. Results PD was gradually reduced with the increase in distance ( 13?41% at 1 cm from the edge to 0?25% at 31 cm from the edge) . With a fixed distance from the edge of the radiation field, there was no significant difference in PD between different depths. A radiation field with a size of 30 cm had a PD about two?fold higher than that with a size of 10 cm. PD increased with the increase in the physical wedge angle and increased by 1% compared with the open field;PD decreased with the increase in the virtual wedge angle and decreased by 2?3% compared with the open field. PD decayed from 13?35% at 1 cm to 0?23% at 31 cm under 6 MV X?ray and from 11?06% at 1 cm to 0?20% at 31 cm under 18 MV X?ray. Dscat er was dominant in the regions close to the edge of radiation field and decreased from 62?45% at 1 cm to 5?71% at 25 cm. In all measurements under 6 MV X?ray, the maximum proportion difference between CC13 ionization chamber and diode ionization chamber was less than 1%. PDs of the breast, thyroid, and lens were 6?72, 2?90, and 2?37 mGy in VMAT mode, 7?39, 4?05, and 2?48 mGy in step?shoot IMRT mode, and 9?17, 4?61, and 3?21 mGy in sliding?window IMRT mode, respectively. Conclusions For the measurement of PDs, the CC13 air?filled ionization chamber and semiconductor diode ionization chamber have good consistency and feasibility under 6 MV X?ray. In clinical practice, the understanding of the relationship of PD with different radiation conditions helps to reduce the doses to organs at risk. Shielding and protective techniques can further reduce dose deposition.

Objective To study the prognostic role of plasma neutrophil gelatinase-associated lipocalin (NGAL) early after renal transplantation.Methods A total of 37 kidney recipients were enrolled from Department of Organ Transplantation,Guangdong Second Provincial General Hospital within a 12-month period of time.Plasma NGAL was measured immediately before and at 6 and 12 h post-transplantation.Changes of serum creatinine were documented daily within the first week postoperation.Acute kidney injury (AKI)/graft rejection during the first week after transplantation was the outcome variable.Results The levels of serum NGAL in the 37 patients were (311.14 ± 102.69),(317.81 ± 107.28) and (312.16 ± 134.80) μg/L respectively immediately before and at 6 and 12 h post-transplantation.There was no significant difference in serum NGAL levels before and 6 h or 12 h after operation (P =0.70,and P =0.96).There were no significant differences in gender and age between the two groups (P =0.29,and P =0.20).There was significant difference in creatinine levels between the AKI group and the non-AKI group (P =0.002) and between pre-operation and 6 or 12 h postoperation.The preoperative levels of serum NGAL in AKI group and non-AKI group were (333.58 ± 116.30) and (300.36 ± 96.15) μg/L (P =0.36),and those were (383.3 ± 147.16) and (286.32 ± 65.97) μg/L (P＜0.01) at 6 h,and (437.33 ± 164.16) and (252.08 ± 57.53) μg/L (P＜ 0.001) at 12 h after operation.The sensitivity and specificity of serumNGAL (317μg/L at 12 h after operation as the cutoff value) predicting AKI was 100％ and 92％ respectively,which was much better than that of serum creatinine at the corresponding time point (sensitivity =66.7％,and specificity =61.9％).Conclusion Plasma NGAL,particularly at 12 h after transplantation,is a very sensitive and specific biomarker for predicting AKI.

Objective To understand the spatial distribution characteristics of wild feces in schistosomiasis endemic areas of Jiangling County,Hubei Province and further explore the source of infection efficiently,so as to provide the evidence for the development of corresponding monitoring and response technology. Methods In 2011,the fresh wild feces were investigated every two months in the selected 15 villages by the severity of historical endemic in Jiangling County. The schistosome miracidi-um hatching method was used to test the schistosome infection of the wild feces. The descriptive analysis and spatial analysis were used for the description of the spatial distribution of the wild feces. Results Totally 701 wild feces samples were collected with the average density of 0.0556/100 m2,and the positive rate of the wild feces was 11.70%(82/701). The results of the re-gression analysis showed a positive spatial correlation between the positive rate of wild feces and the rate of human infection,the area with infected Oncomelania hupensis and the number of fenced cattle,and the corrected R2 of the model was 0.58. Conclu-sion The infection rate of wild feces is positively correlated with the rate of human infection,area with infected O. hupensis and number of fenced cattle in space in Jiangling County,so the prevention and control measures could be conducted according to the spatial distribution of the positive wild feces.