The supporting role of library in social service for continuous medical education under Internet+ environment was elaborated in aspects of resources, public learning platform and variant information services after the feasibility of medical academic library to service for continuous medical education under Internet+ environment was analyzed from the need of continuous medical education users.

Castleman Disease ; complications ; Dendritic Cell Sarcoma, Follicular ; complications ; Humans

Purpose To investigate the clinicopathological features,diagnosis and differential diagnosis of myxoid synovial sarcoma (MSS).Methods Clinicopathological changes and immunophenotype were retrospectively evaluated in two MSS cases collected from Fujian Provincial Hospital,conbined with genetic mutation analysis.The relevant literatures were reviewed to explore its clinical and pathological features of this tumor.Restilts The two cases,one man and one woman,aged 71 and 15years,respectively.Tumor was located in the left down abdomen in case 1,and left frontal temporal lobe in case 2.Histopathologically,at low magnification in case 1,the tumor was nodular,which was made up of areas of hypercellularity and hypocellularity.In some areas of hypocellularity,the tumor cells were arranged in fascicular,story-form,sheet arrangements with mucoid degeneration.In hypercellularity area,the tumor cells were arranged in fascicular,fish bone-liked arrangenents.At low magnification in case 2,the tumor was nodular,which was made up of areas of hypercellularity and hypocellularity.In hypocellularity area,the tumor cells were arranged in net-like,sheet arrangements,and fascicular,sheet arrangements in case 2.In some area,the tumor cells were epithelioid with cluster distribution,without infringing brain tissue.Immunohistochemically,the tumor cells were diffusely positive for BCL-2,vimentin,and α-SMA and EMA were partially positive,while CD34,CD57,S-100,CD117,PLAP were negative.However,in case 2,only BCL-2 was positive,and MyoD1,GFAP,Olig-2,EMA,Syn,CD99,CgA,S-100,Myogenin,STAT6,CD34,desmin and α-SMA were negative.Molecular detection SYT-SSX fusion gene was detected in both cases.Conclusion MSS is a rare malignancy of soft tissue.The diagnosis of MSS depends on molecular pathology.The clinical and pathological findings are different from mucinous fibrosarcoma and solitary fibrous tumor.The treatment is surgical resection,combined with radiotherapy,with poor prognosis.

Objective To improve the quality of the clinical hematologic examination laboratories in national free preconception health examination project by using randomized blind sample test in the external quality assessment (EQA ) schemes .Methods Blind samples for clinical hematologic examination were prepared as higher ,middle ,lower three levels .Samples were dispensed in u‐nified way which included 4 times conventional EQA and in random way which included 1 time blind sample test .Samples will be tested by Clinical hematologic examination laboratories in national free preconception health examination project .The feedback re‐sults were summarized and analyzed by EQA organizer .Results In 4 times of conventional EQA ,the rates of accepted score of 134 laboratories were 72 .4% ,97 .8% ,97 .0% and 98 .5% respectively .The rates of accepted score in last three times were statistically significant higher than that in the first time(P<0 .05) .However ,the rates of accepted score (84 .3% ) in randomized blind sample test were significant lower than that(97 .0% ) in conventional EQA which was conducted at the same time(P<0 .05) .Conclusion The use of randomized blind sample test may help the EQA organizer to find the problems in laboratories participated EQA and find effective way to improve the quality of the laboratories .

Total 1350 subjects were selected by cluster random sampling from Chongwen District and Shijingshan District in Beijing with a populations of 100 000.Chongwen District represented a typical urban district and Shijingshan represtnted a newly extended urban district.Qualified investigators conducted face-to-face survey using the uniform questionnaire and measurement, dealing with the knowledge, attitude and behavior for risk factors of stroke in two districts.The results showed:in Chongwen District, the awareness rates of "the diagnostic criteria of hypertension", "antihypertensive drugs can lower the risk of cardiocerebral vascular disease", and "criteria for obesity" were 71.3%, 87.3% and 22.9% respectively,which were significantly higher than those in Shijingshan District.The awareness rate of "bad temper may increase the risk of cardiocerebral vascular disease" was lower in the Chongwen District.There were no significant differences in attitude between two districts.In Chongwen District the level of three risk factors (smoking and obesity) was significantly lower than Shijingshan, but action of self-examination was also significantly lower.Generally, there was higher level in health knowledge and lower level of risk factors in Chongwen District.The hypertension-related knowledge and behavior was not entirely consistent.It is necessary to transform knowledge into behavioral changes or intervention of risk factors in population with high awareness like Chongwen District.

OBJECTIVETo assess the relationship between nodular goiter and hepatitis C virus infection.

METHODSNinety-seven cases of early treatment in patients with chronic hepatitis C were collected for analysis.Data on patient age,sex,hepatitis duration and other general information were collected.In addition, data on clinical measures of thyroid function (including T3, t4, tSH) and thyroid autoantibodies (thyroid peroxidase antibody TPO-Ab, thyroglobulin antibody Tg-Ab), as well as findings from thyroid dimensional ultrasonography were collected. One hundred and eleven cases of early treatment in patients with chronic hepatitis B and 106 eases of females 40 years old or older with high risk of nodular goiter were collected for use as controls.The relationship between nodular goiter with thyroid function, thyroid autoantibodies levels,sex,age,and hepatitis C virus infection were statistically analyzed.

RESULTSThe prevalence rates of nodular goiter in the chronic hepatitis C group, the chronic hepatitis B group and the more than or equal to 40 year-old women with high risk of nodular goiter were 53.6%,36.9% and 59.4% respectively.The prevalence rates of nodular goiter in the chronic hepatitis C group and the more than or equal to 40 year-old women with high risk of nodular goiter were significantly higber than that in the chronic hepatitis B group (x² values: 5.820 and 10.996, P < 0.05). The average age of patients with chronic hepatitis C combined with nodular goiter was significantly higher than their counterparts without goiter (F=6.408, P < 0.05),and the prevalence rate in the more than or equal to 40 year-old women with high risk of nodular goiter was significantly higher than that of their counterparts who were less than 40 years-old (60.0% vs. 23.5%; x² =7.499, P less than 0.05). The prevalence of nodular goiter in patients with chronic hepatitis C was significantly greater for females than for males (62.1% vs. 41.0%; x 2 =4.152, P < 0.05).The prevalence of nodular goiter in patients with chronic hepatitis C was also significantly higher for females more than or equal to 40 years old than for males (70.2%, 33/47 vs. 45.5%,15/33; x² = 4.952, P < 0.05).The duration of hepatitis, thyroid function and thyroid autoantibodies were similar between the patients in the chronic hepatitis C group with or without nodular goiter.

CONCLUSIONSThe patients with chronic hepatitis C had a higher prevalence of nodular goiter,with an average of up to 53.6%, than the patients with chronic hepatitis B,and the women the more than or equal to 40 years old had even higher prevalence, at 70.2%, suggesting that patients with chronic hepatitis C should be routinely examined by thyroid ultrasound. Thyroid function and thyroid autoantibodies were not correlated with prevalence of goiter among the chronic hepatitis C patients.

At present, the development of biobank in China is still at the initial stage, and there are many problems, such as lack of scientific management and sharing mechanism, insufficient application of transformation and weak sustainable development. Through constructing the ethical challenge of biobank, the author draw out the rights protection claims of biological sample sources, such as the informed consent of samples source and the privacy protection of samples management. In order to achieve the balance between the protection and sharing of biobank construction, we should improve the awareness of privacy protection, take effective means of privacy protection and fully consider and foresee ethical issues after rapid development of technology. Finally, it is pointed out that the principle of public welfare, the principle of fairness in the distribution of results and the predictive principle should be reflected in the transformation of results.

It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.

Taking the current situation and problems of medical humanities education as the background, the concept of narrative medicine was used to sort out and integrate various course materials of medical humanities, explore the multi-link linkage mode of medical humanities education, and organically integrate medical humanities courses scattered in medical education activities such as medical ethics, health law, doctor-patient communication, and health policy science with teaching stages, teaching resources, and teaching methods, forming vivid narrative medical materials throughout the entire process of medical humanities education, and improving teaching efficiency by sharing and optimizing resources. Through questionnaire analysis, it was found that there are many unsatisfactory aspects of medical humanities education. Further analysis of the issues focuses on the contradiction between learning willingness and time allocation, the lack of synchronization between teaching and social development, the lack of integration between courses, and insufficient innovation in teaching methods. Based on these, countermeasures were put forward to integrate narrative medical materials of medical humanities courses and build a platform for the application and communication of narrative medical materials.

It is worth pondering how to seek advantages and avoid disadvantages in stem cell clinical research and give full play to the advantages of technology for the benefit of mankind. Through the analysis of the status of stem cell clinical research, including technology and related management methods, proposed the main problems existing in stem cell research, such as the risks of technological uncertainty, ambiguity between research and treatment, over-treatment and technological innovation. Then this paper discussed the ethical and legal risks of stem cell clinical research in China, mainly related to the problems that the construction of laws and regulations is lagging behind, the regulatory challenges of administrative departments are large, the ethical awareness of researchers needs to be further improved, the principle of fairness and justice is not taken into account, the research platform construction of medical institutions is not in place and the protection system of subjects is imperfect, and the organization construction and review capacity of the ethics committee is still lacking.