In order to carry out subject librarian service and improve electronic literature service in hospital libraries, the utilization of electronic literature databases in 240 clinical nurses of class A and B hospitals in Jinan, Qingdao and Jining was investigated with questionnaire, which showed the new features of clinical nurses in awareness and utilization of electronic literature databases under the new turn of hospital class evaluation.

OBJECTIVE:To observe clinical efficacy and safety of milrinone in the treatment of persistent pulmonary hyperten-sion of newborn. METHODS:52 newborns with persistent pulmonary hypertension were divided into control group and observa-tion group according to random number table,with 26 cases in each group. The control group were given mechanical ventilation and intravenous prostaglandin therapy. Observation group was treated with Milrinone injection at loading dose of 50 μg/kg,10 min intravenous injection,maintenance dose of 0.75 μg/(kg·min). Both groups received treatment for 48 h. Clinical efficacies of 2 groups were compared as well as SpO2,PaO2,OI,PAP,PAMP and SV before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:Total effective rate of observation group was 92.31%,which was significantly higher than 80.77% of control group,with statistical significance (P<0.05). Before treatment,there was no statistical significance in SpO2,PaO2,OI,PAP,PAMP and SV levels between 2 groups(P>0.05). After treatment,above indexes of 2 groups were im-proved significantly;SpO2,PaO2,OI and SV levels of observation group were significantly higher than those of control group, while PAP and PAMP levels were significantly lower than those of control group,with statistical significance(P<0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Milrinone shows significant therapeutic efficacy in the treatment of persistent pulmonary hypertension of newborn,and can significantly improve persistent pulmonary hypertension and increased oxygen con-tent of blood with good safety.

Objective To assess the safety of living environment by the elderly, further clarify the relevant factors of the elderly fall in the living environment. Methods The self- made assessment form of fall-related factors of living environment for elderly patients was used to survey 1 076 elderly. Likert five grades score was used for each item, and the higher score demonstrated the safer living environment. Results In the assessment of the safety of living environment, the indoor physical environment (3.94 points), home furniture safety (3.66 points) score was better;home ground and the channel (3.32 points) and outdoor activities places (3.57 points) score was lower. Scores of home′s ground and channel, furniture safety, indoor physical environment and living environment of urban elderly were (23.56 ± 6.49), (44.52 ± 7.72), (11.93 ± 2.49), (105.03 ± 17.82) points, which were better than (22.46 ± 6.39), (42.73 ± 7.95), (11.53 ± 2.39), (101.55 ± 18.15) points of rural elderly (t=2.471-3.495, P <0.05). Conclusions The indoor physical environment, home furniture safety got higher scores, and the scores of ground-channel environment and outdoor activities places were relatively lower. Scores of the safety of living environment in urban are better than in rural. It suggests the elderly living environment need to reduce the incidence of falls.

OBJECTIVE:To evaluate the feasibility of using CYP2C19 gene to guide the use of antiplatelet agents in acute cor-onary syndrome(ACS)patients undergoing interventional operation in China from the viewpoint of pharmacoeconomics. METH-ODS:Based on global PLATO trial data,the patients were divided into 3 groups according to treatment strategies(clopidogrel group,ticagrelor group,genetic test group). By applying Treeage Pro 2011 software,short-term decision tree model and long-term Markov model were established,and related data were imported to evaluate cost-effectiveness of different treatment strategies. RE-SULTS&CONCLUSIONS:For ACS patients,according to the level of GDP in China,conventional use of ticagrelor is of pharma-coeconomic advantage for in Shanghai and uninsured patients insured patients;the use of antiplatelet agents guided by CYP2C19 gene test is of pharmacoeconomic advantage among nationwide insured patients.

Word frequency and co-word analysis of key words and comparative analysis of hot spots and topics in core journals-published papers on health policy in China from 2004 to 2008 and from 2009 to 2013 showed that health policy research and health system reform promoted each other and developed with each other, the research tipics on health policy were scattered and expanded rapidly , the focus of researches was more clear with stress laid on their macro-aspects, and the research methods were variable.

Technologies for the trans-institutional sharing of scientific data were studied with the sharing of nucleic acid sequence data as the study object , such as leaving a flexible space for implementation of the unified standards in working out the criteria for data sharing , implementing regular point to point data sharing and updating in agree-ment of institutional league , and providing multiple data services according to the unified working process by giving considerations to the local demands .The significance of trans-institutional sharing of scientific data under the insti-tutional league model was summarized for the reference in constructing the scientific datasharing platform.

Objective To discover the common characteristics of award winning medical and health science and technology achievements in Shandong province,and provide a useful reference for the Medical Science Research Management.Methods Statistical analysis was conducted on the 2014 Shandong provincial science and technology award winning projects of medical and health.Results The rate of award winning in Shandong Provincial Science and Technology Award in 2014 was 37.42％,and declared the results of medical and health category winner was 27.91％.While the winners percentage was 35.23％-58.59％ in surrounding eight provinces in the same year.In the awarding group,the innovation points,popularize and applying in scientific and technical achievements,patent for invention,professional inventions,authorized patents within 5 years,SCI publication and its number within 5 years in turn was 3.79,1.25,1.81,1.81,1.83,5.48 and 4.23,respectively.In contrast,the numbers in the non-awarding group was 3.36,0.81,0.86,0.99,0.93,3.40 and 2.76.Conclusions Shandong Provincial Science and Technology Award is very competitive to win and is more difficult for the medical and health class.It is helpful with an original innovation achievement,such as service in-ventions or SCI publications within 5 years.The focus of Medical Science Research Management should be made accordingly adaptation.

Objective To study the imaging value in diagnosis of congenital cholangiectasis.Methods The clinical and imaging (CT and ultrasonics) data of 6 patients with congenital cholangiectasis were restrospectively analyzed with literature review.Results According to Todani's classifications of cholangiectasis,there were type I in one case,CT showed cystic hypodense shadow with thin and smooth wall;type IV in 4 cases,CT showed cystic or fusiform extension of intra-and extra-hepatic bile ducts;type V in one case,CT showed cystic extension of intra-hepatic bile ducts,and the central spot enhancement could be seen on contrast-enhanced CT scan.6 cases underwent ultrasonic examinations,ultrasound showed extension of intra-and extra-hepatic bile ducts in 6 cases,choledochal cyst in one.4 cases suspected with congenital cholangiectasis,and misdiagnosed in one.In company with cholecystitis and cholelithiasis in one,biliary carcinoma in one and cirrhosis in one.Conclusion CT and US are of important value in diagnosis of congenital cholangiectasis.

ABSTRACT:In this study ,we elucidated the predictors of progression to liver failure during severe acute exacerbation .We analyzed 69 consecutive patients with severe acute exacerbation of chronic hepatitis B for clinical outcome and factors that influ‐enced the development of liver failure ,including viral genotype ,PC (G1896A) and BCP (A1762T/G1764A) mutants .Thirty‐three (47 .8% ) severe acute exacerbation patients progressed to liver failure .Multivariate analysis identified serum bilirubin (TB>256 μmol/dL ,P=0 .008) and prothrombin activity (PTA<40% ,P<0 .001) as significant determinants of progression to liver failure .HBeAg negativity (P=0 .065) and PC mutant (P=0 .090) were associated with the progression to hepatic de‐compensation .Serum total bilirubin ,prothrombin activities ,HBeAg status and PC mutant were predictors of clinical outcome in patients with severe acute exacerbation of chronic hepatitis B .

Objective To investigate the features and risk factors associated with lymph node metastasis in colorectal neuroendocrine neoplasm.Methods Clinical and pathological data of 63 patients with colorectal neuroendocrine neoplasm treated in Yinzhou People's Hospital between June 1997 to December 2012,were analyzed retrospectively.Comparisons of categorical data and univariate analysis of risk factors of lymph node metastasis were conducted by x2 test,multivariate analysis was conducted by Logistic regression analysis.Results Of the 63 patients the rate of regional lymph node metastasis was 30％ (19/63) with 58％ limited to para-intestinal lymph nodes in 11 cases,26％ limited to mesenteric lymph nodes in 5 cases,and 16％ limited to mesenteric root central lymph nodes in 3 cases.No metastasis exceeding central lymph nodes was observed.According to univariate analysis,tumor size,depth of invasion,ulceration in mucous membrane,invasion of lymphatic vessel and pathological grading suggested by WHO were related to regional lymph node metastasis (P ＜ 0.01).Multivariate regression analysis revealed that tumor size,invasion of lymphatic vessel and pathological grading were independent risk factors for lymph node metastasis in colorectal neuroendocrine neoplasm (P ＜ 0.05).Conclusions Colorectal neuroendocrine neoplasm with larger tumor size,invasion of lymphatic vessel or higher grade (G2,G3) has high risk of regional lymph node metastasis.