The paper introduces the system structure of the knowledge discovery system of digital library of medical university,including knowledge service interaction layer,knowledge discovery processing layer,data mining & transmission layer and basic data resource layer,and discusses the knowledge service mode of the digital library of medical university supported by knowledge discovery,namely,the knowledge service mode based on embedded system,document database and collaborative mode.

Objective:To investigate the clinical efficacy of mechanical solitaire AB stents thrombectomy combined with intra-arterial thrombolysis in the treatment of patient with acute ischemic stroke.Methods:Fifteen patients with acute ischemic stroke admitted into our hospital from August 2014 to August 2016 were treated with mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis.The National Institutes of Health Stroke Scale score (NIHSS) of all patients were evaluated before and after treatment to compare the clinical efficacy.The prognosis ofpatients between two groups were compared via evaluating modified Rankin score (mRS)and gelasijia coma score (GCS).Results:After mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis treatment,14 patients achieved complete or part recanalization,and 1 patient was terminated treatment due to vital signs instability,and the rate ofrecanalization was 93.3％.The NIHSS score of patients before treatment was 12.93± 4.25,which was much higher than that after treatment (4.33± 1.45,P＜0.05).After follow-up by 3 months,the good mRS scores were obtained in all 18 patients,including 2 patients with mRS score of 2,5 patients with 1,and 8 patients with 0.Additionally,there was no patient with re-obstruction during follow-up period.Conclusion:Mechanical thrombectomy with solitaire AB stents combined with intra-arterial thrombolysis had a good capability and safety in the treatment of patients with acute ischemic stroke.

Background:With the deepening of researches on etiology of gastrointestinal bleeding,bleeding caused by pancreatic diseases has been understood better by the clinicians. Upper gastrointestinal bleeding (UGIB)is an uncommon but highly lethal complication of pancreatic diseases. Aims:To analyze the clinical characteristics of UGIB caused by pancreatic diseases for improving the diagnosis and management of this condition. Methods:A total of 22 inpatients who were diagnosed as UGIB caused by pancreatic diseases from Sep. 2010 to Sep. 2016 at Daping Hospital,the Third Military Medical University were recruited and analyzed retrospectively. Results:There were 15 males and 7 females;the disease was more prevalent in young patients than in middle-aged and elderly patients (45. 5% vs. 31. 8% and 22. 7%). The top five causes of bleeding were as follows:stress ulcer related to acute pancreatitis (36. 4%),pancreatic pseudocysts related to chronic pancreatitis (18. 2%),severe acute pancreatitis (13. 6%),post-operative bleeding related to pancreatic surgery (9. 1%)and left-sided portal hypertension (9. 1%). The diagnosis was commonly made by gastroscopy, abdominal contrast-enhanced CT and angiography. Ten patients received medical therapy only,6 were treated by surgical operation,5 by endoscopic hemostasis,and 1 by angioembolization. Hemostasis was achieved in 18 patients (81. 8%), and rebleeding occurred in 4 patients,of which two received medical therapy initially. Two elderly patients died of uncontrollable bleeding and multiple organ failure,respectively. Conclusions:UGIB caused by pancreatic diseases are prone to occur in young and middle-aged males. Pancreatitis and its complications are the major cause of this condition. Medical therapy is ineffective for most of the patients and a multidisciplinary approach of endoscopy,transarterial intervention and surgery is recommended.

AIM To investigate the effects of D galactose on bone contents of hydroxyproline(HOP), calcium, microelements and activities of antioxidation in mice. METHODS Twenty female kunming mice at three months of age were used in this study. D galactose at dose of 1 g?kg -1 ?d -1 was given subcutaneous injection daily to the mice for 42 days. The right femurs were collected to determine the bone dry weight, bone hydroxyproline content, bone calcium, and bone microelements. The activities of catalase (CAT), glutathione peroxidase (GSH Px) and superozide dismutases (SOD) in blood, and contents of methylenedioxyamphetamine (MDA) in serum, lipofuscin in liver were determined. RESULTS The bone dry weight, hydroxyproline, calcium of bone decreased significantly in D galactose treaded group(compared with control group, P

The expression of human general control of amino acid synthesis protein 5 (hGCN5) in human Burkitt's lymphoma Daudi cells in vitro, effects of Trichostatin A (TSA) on cell proliferation and apoptosis and the molecular mechanism of TSA inhibiting proliferation of Daudi cells were investigated. The effects of TSA on the growth of Daudi cells were studied by 3-(4, 5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium (MTT) assay. The effect of TSA on the cell cycle of Daudi cells was assayed by a propidium iodide method. Immunochemistry and Western blot were used to detect the expression of hGCN5. The proliferation of Daudi cells was decreased in TSA-treated group with a 24 h IC50 value of 415.3979 microg/L. TSA induced apoptosis of Daudi cells in a time- and dose-dependent manner. Treatment with TSA (200 and 400 microg/L) for 24 h, the apoptosis rates of Daudi cells were (14.74+/-2.04) % and (17.63+/-1.25) %, respectively. The cell cycle was arrested in G0/G1 phase (50, 100 microg/L) and in G2/M phase (200 microg/L) by treatment with TSA for 24 h. The expression of hGCN5 protein in Daudi cells was increased in 24 h TSA-treated group by immunochemistry and Western blot (P<0.05). It was suggested that TSA as HDACIs could increase the expression of hGCN5 in Daudi cells, and might play an important role in regulating the proliferation and apoptosis of B-NHL cell line Daudi cells.

Objective To compare the safety and clinical efficacy between paclitaxel liposomes and paclitaxel in patients with advanced esophageal cancer .Methods A total of 90 patients with advanced esophageal cancer were enrolled into this study and were randomly divided into paclitaxel liposomes treatment group(treatment group) and paclitaxel treatment group(control group) . The patients of each group were treated with paclitaxel liposomes or paclitaxel 80 mg/m2 intravenously on day 1 and 8 ,and nedapla‐tin 75 mg/m2 intravenously on day 1 ,respectively .After two cycles of chemotherapy ,three weeks per period ,we evaluated the short term efficacy and adverse reactions according to the WHO standard .Results The short term efficacy between control group and treatment group showed no significance statistically (P>0 .05) .However ,the incidence of allergic reactions in the treatment group was significantly lower than control group (P<0 .05) .Conclusion Paclitaxel liposomal or paclitaxel combine with nedaplatin was effective equivalently in the treatment of patients with advanced esophageal cancer .But the allergic reactions of paclitaxel liposomal were lower than paclitaxel .It is worthy of clinical promotion .

Objective To investigate the related risk factors caused the retained common bile duct (CBD)stones after laparoscopic cholecystectomy,to provide the evidence for preventing from retained common bile duct stones of laparoscopic cholecystectomy.Methods Selected 654 cases of laparoscopic cholecystectomy patients as the objects whom hospitalized in Beijing Chuiyongliu Hospital from January 2002 to June 2013.All cases were divided into the group of retained CBD stones (27cases) and the group of non-retained CBD stones (627 cases).Collected the potentially relevant factors of two groups with the retained CBD stones,including medical history of jaundice and pancreatitis,common bile duct internal diameter (B Ultrasound) ≥ 8 mm,acute cholecystitis,emergency surgery,gallbladder removal order,calot triangle adhesion,sludge calculus,stones neck incarcerated,fulltype stones,cystic duct thickening,cystic duct reserved≥ 1 cm,the minimum diameter stones ≤5 mm,the number of gallbladder stones ≥ 5,partial cholecystectomy,purulent bile.Statistics analyses was proceeded using the IBM SPSS 20.0.Result Through dichotomy logistic regression analysis to the univariate analysis results with statistical significance,sorted the results according to the influence degree,found the independent risk factors:common bile duct internal diameter (B Ultrasound) ≥8 mm,gallbladder removal order (retrograde removal),medical history of jaundice pancreatitis,cystic duct reserved ≥ 1 cm,sludge calculus,in total of 5 indexes,which caused the retained CBD stones after laparoscopic cholecystectomy.Conclusion There are several independent risk factors for retained CBD stoes after LC such as medical history of jaundice and pancreatitis,common bile duct internal diameter (B Ultrasound) ≥ 8 mm,the order of cholecystectomy (retrograde remoral),shudeg calculus and the remaining length of bile duct ≥ 1 cm.The surgeons should pay close attention to them and take appropriate measures in the preoperation and intraoperation of LC,which contribute to preventing the acurence of postoperative retaimed CBD stone.

Objective To investigate the clinical characteristics of adult patients with community acquired pneumonia (CAP) caused by acute Mycoplasma pneumoniae (MP) infection, and provide evidence for early identification of MP infection. Methods A prospective, multicenter and cross-sectional study was conducted. 452 adult patients with CAP admitted to Beijing Friendship Hospital, Beijing Guangwai Hospital and Air Force General Hospital from August 2011 to October 2015 were enrolled. The diagnosis of adult MP infection was confirmed by the combined application of double serum antibody titer and MP-DNA nested polymerase chain reaction (PCR) through testing serum and throat swab samples from patients to identify acute infections, past infections, pathogen carrying, and non-MP infection. The clinical characteristics of patients with acute MP infection were summarized by analyzing the baseline data, clinical parameters and chest imaging findings in patients with non-MP infection and acute MP infection. Results Of 452 enrolling patients with CAP, 288 patients (63.7%) suffered from MP infection, and 164 patients (36.3%) with non-MP infection. There were 56 patients (12.4%) with acute infection, 10 patients (2.2%) with past infections, 222 patients (49.1%) with pathogen carriers in MP infective patients indicating susceptible to MP in adult patients. There were no significant differences in gender, age, fever extent, duration of fever, sputum production, shortness of breath, rales, underlying diseases, etc. between non-MP infection and acute MP infection patients, which suggested that the baseline data of the two groups were equilibrium. The acute infection rates of MP in summer and autumn (43.9% and 43.5% respectively) were more than those in spring and winter (13.3% and 12.3% respectively). It was shown by laboratory examination results that serum cardiac troponin T (cTnT) increased significantly in acute MP infectious patients more than that in non-MP infection patients (30.4% vs. 9.8%, P < 0.01), which indicated that patients with acute MP infection were more likely to have myocardial injury. While there were no significant differences in blood routine, blood electrolytes, blood glucose, as well as heart, liver and kidney function between the two groups. It was shown by chest imaging that the diffuse lesions (57.1% vs. 37.2%), mediastinal lymphadenopathy (60.7% vs. 37.8%) were less founded in the middle lobe of the right lung (12.5% vs. 32.9%), which were the main manifestations in patients with acute MP infection as compared with non-MP infection patients with statistical difference (all P < 0.01). There were no significant differences in the chest imaging performances of pulmonary ground glass shadow, lobar and segmental consolidation, patch shadow, a shadow, acinar nodules, grinding glass density nodules, the photic zone, hilar lymphadenopathy and pleural effusion occurrence between the two groups. Conclusion Adult CAP patients are easy to carry MP, myocardial damage is a common complication in acute MP infectious patients which are characteristic of image findings of diffuse lung disease, mediastinal lymphadenopathy and less founded in the middle lobe of the right lung.

Objective To analyze the isolation rates and antimicrobial resistance of Acinetobacter baumannii (AB) from intensive care unit (ICU)between 2010 and 2013,and provide evidence for clinical anti-infective therapy. Methods The isolation and antimicrobial resistance of AB from ICU between 2010 and 2013 were analyzed retro-spectively.Results A total of 1 413 pathogenic strains were isolated,556(39.35%)of which were AB,isolation rates in each year were 39.45%,41 .35%,29.44%,and 40.53% respectively.AB were mainly isolated from lower respiratory tract (75.72%).Antimicrobial susceptibility testing results showed that AB had low resistance rates to cefoperazone/sulbactam(5.85%)and amikacin (17.45%);detection rates of multidrug-resistant and extensively drug-resistant AB increased from 9.63% and 3.70% to 42.50% and 31 .88%,respectively (both P < 0.001 ). Conclusion AB is the common pathogen in ICU,antimicrobial resistance is serious,isolation of multidrug-resistant and extensively drug-resistant AB increased year by year;intensifying the monitoring of drug resistance is helpful for the treat-ment and prevention of AB infection.

Background:Small intestinal bleeding is difficult to diagnose and treat because of its complex etiology and limit to examination method. Aims:To analyze the etiology,diagnosis,treatment and prognosis of small intestinal bleeding. Methods:The clinical data of 118 consecutive patients with small intestinal bleeding admitted from Oct. 2006 to Oct. 2016 at Daping Hospital,the Third Military Medical University were retrospectively analyzed. Results:Melena was the most common manifestation of small intestinal bleeding (41. 5％),followed by dark bloody stool,positive fecal occult blood test,hematochezia,and anemia with unknown cause. The major causes of bleeding were benign or malignant tumors (43. 2％),vascular lesions (28. 0％)and inflammatory lesions (15. 3％). Diagnosis was made by means of capsule endoscopy,colonoscopy,digital subtraction angiography (DSA),barium meal examination,multi-slice CT (MSCT)and CT enterography (CTE). Forty-one patients were treated by surgical operation,7 by selective arterial embolization,2 by endoscopic therapy,56 by conservative therapy,and all these patients achieved hemostasis. One patient died of massive hemorrhage and 11 were discharged with giving up of treatment. Conclusions:The leading cause of small intestinal bleeding is tumor,followed by vascular and inflammatory lesions. Capsule endoscopy is able to make definite diagnosis with high accuracy,and MSCT is the most widely used diagnostic approach. In addition to conventional treatment,surgical operation,interventional and endoscopic therapies also play important roles in treating small intestinal bleeding.